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MODEL-BASED SYSTEMS ENGINEERING OF PHOSPHATE
BENEFICIATION PROCESSES
Mariem Ait Bakader Applied Organic Chemistry Laboratory, Faculty of Sciences and Technics,
Sidi Mohamed Ben Abdellah University, FES
FES, MOROCCO
Complex Systems Engineering Laboratory
Mohammed VI Polytechnic University, BENGUERIR
BENGUERIR, MOROCCO
Laurent Deshayes Complex Systems Engineering, Mohammed VI Polytechnic University, BENGUERIR
BENGUERIR, MOROCCO Email: [email protected]
Mohammed El Asri Applied Organic Chemistry Laboratory, Faculty of Sciences and Technics,
Sidi Mohamed Ben Abdellah University, FES, MOROCCO
FES, MOROCCO Email : [email protected]
ABSTRACT
The fourth industrial revolution is being fostered in many countries to make more efficient and flexible plants.
Industry 4.0 target is to get a more competitive industry. Under this framework, improvement of mineral
processing requires knowledge of previous methods and current technology in order to develop new techniques
and approaches. As phosphate deposition decreases, the need for new recovery methods keeps growing. From
this perspective, the need for control and optimization of existing processes becomes a necessity. It also
includes the development of equipment with more advanced digitized components. In this paper, we adopted
a system engineering-based approach, which consists on modeling and formalizing knowledge collected in the
field. A well understanding of phosphate value chain allows both driving and optimizing current processes. In
addition, we used this approach to model information flows in which we integrated a specific equipment in
the overall process. A specific type of mining processes were studied with aim of giving feedback on the
implementation of system modeling for mineral processing.
Keywords: Phosphate Beneficiation, Mineral Processing, Complex System Engineering, Control,
Optimization.
INTRODUCTION
Why focusing on Phosphate ore Beneficiation?
Phosphate ore is a nonrenewable resource but it is essential for agriculture, as a raw material for fertilizers.
Phosphates cannot be really substituted and recycled. Feeding the ever-growing world’s population is
becoming a challenge and phosphate needs are always bigger (Sis and Chander, 2003).
According to United Nations Food and Agriculture Organization (FAO), the mineral composition of
Phosphate ore is depending mainly on its origin. Here are the four main classes of Phosphates:
Fluoroapatite:
Ca10(PO4)6F2 Igneous or metamorphic origin
Hydroxyapatite: Ca10(PO4)6(OH)2 Igneous, metamorphic or
biogenic origin
Carbonated hydroxyapatite: Ca10(PO4, CO3)6(OH)2 Biogenic origin
Francolite:
Ca10-x-yNaxMgy(PO4)6-
z(CO3)zF2+z
Marine or erosion origin
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Depending on several geological and physical conditions, proprieties of apatites found in different deposits
may be different. As Francolite is metastable, it can be affected by leaching, metamorphism or with time. It
has indeed been found that the carbonation rate of francolite decreases with time. (Birken et al. 2016)
Phosphate rock is an important mineral commodity used in the production of phosphoric acid. The majority
of phosphoric acid is produced by the “wet process,” in which phosphate rock is reacted with sulfuric acid to
produce phosphoric acid and gypsum (calcium sulfate dihydrate). The wet process demands a phosphate rock
feed that meets certain specifications in order to produce phosphoric acid efficiently and economically
(Kawatra and Carlson, 2014).
As in any mining industry, the easiest phosphate deposits to extract and purify have been exploited first.
Estimated phosphate resources are directly dependent on the ability to take advantage of less pure geological
veins, so there is a continuing interest in improving the enrichment of phosphate ores. This optimization of
such processes requires mastering existing processes and control through the integration of intelligent sensors.
The remainder of this paper is organized as follows: Section 2 highlights phosphate beneficiation activity.
Section 3 presents system engineering approach and SysML language. Throughout the paper, the example
diagrams will be based on the Systems Engineering of a mineral activity production line introduced in Section
4.The conclusion and ideas for future work are presented in Section 5.
PHOSPHATE BENEFICIATION ACTIVITY
Phosphate rock is the primary source of phosphorus. The phosphate ores are extensively used in the fertilizer
industry. The grade of rock phosphate consumed varies from 27 to 35% in fertilizer industry and from 30 to
35% in the chemical industry. (Sis and Chander, 2003).
Siliceous phosphate ores are generally beneficiated by a two-stage flotation technique using amine and fatty
acids for silica based gangue and phosphates respectively. The beneficiation of phosphate ores containing
carbonaceous gangue is complicated because of the similarities in the chemical behavior of the minerals
present (Somasundaran 1975)
Flotation feed preparation—washing, sizing, and desliming
Preparation of phosphate starts with the activity of mining, usually by using draglines, the ore is then made
into a slurry, and transported to wash plant by pipelines. There are different equipment for washing; trommels,
log washers, and sandwich screens (Lawver et al.1978)
After mining, screens are used to separate the +16-mesh pebble fraction, which has traditionally been high
enough quality to be considered phosphate concentrate. Log washers use a countercurrent wash-water flow to
remove clay slimes from ores. (Kawatra and Carlson, 2014).
In phosphate processing, hydrocyclones used are operating at high capacities and they give a specified cut
size. The basic diagram of a hydrocyclone is shown in Figure.1.
Figure 1.Hydrocyclone
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According to (Lawver et al.1978), the hydrocyclone consists mainly of a cylindrical section and a
conical one. The feed slurry enters tangentially through the inlet, generating a swirling “cyclone” action. This
flow imparts centrifugal forces on the slurry, which moves coarser, denser particles to the outside wall of the
cyclone and eventually out the underflow. The finer particles stay in the liquid and are carried away with a
large portion of the fluid through the vortex finder into the overflow. Hydrocyclone efficiency for a specific
application depends largely on the design parameters of the cyclone itself (cyclone diameter, angle of conical
section, diameter of the inlet etc.), operating parameters (feed flow rate, % solids in slurry, etc.), and feed ore
characteristics (particle size distribution, particle density, particle shape, etc.). Hydrocyclones used for
phosphate ore desliming are typically 24−30 inches (61−76.2 cm) in size.
COMPLEX SYSTEMS ENGINEERING
3.1. System Engineering (SE) & Model-Based Systems Engineering (MBSE)
(Roques, 2013) presented the System engineering (SE) as a general methodological approach that
encompasses all the appropriate activities to design, develop and verify a system that provides a cost-effective
and efficient solution to a customer's needs, while satisfying all stakeholders.
The transformation of an emerging need into the definition of a solution-based system implements multiple
intellectual activities gradually moving from abstract concepts to the rigorous definition of products. It is
necessary to rely on representations of both the problem and possible solutions at different levels of
abstraction, to apprehend, conceptualize, design, estimate, simulate, validate, justify choices, and
communicate. This is the role of modeling.
Works implemented in SE have always used models from representations more concrete such as reduced plans
or models, to more abstract, such as systems of equations. Graphics tools are the most used by engineers
because they can easily represent complex systems. Here are some of these tools presented below.
According to the International Council on System Engineering (INCOSE), “Systems Engineering is an
interdisciplinary approach and means to enable the realization of successful systems. It focuses on defining
customer needs and required functionality early in the development cycle, documenting requirements, then
proceeding with design synthesis and system validation while considering the complete problem”. MBSE is
an extension of the systems engineering approach that focusses on capturing product properties and
engineering information consequently within models instead of predominantly using documents. The various
representations from the MBSE are Requirements, Function, Logic, Behavior, and Structure. The resulting
analysis provides traceability from requirement to component and vice versa.
For MBSE the most common model language to use is SysML. While SysML is a highly capable language, it
is also fairly complex. SysML is derived from the UML language and most of its features are directly reused
from the UML.
The section below provides an overview of the core parts of SysML that highlights most of its benefits for
systems engineers. It presents the basic SysML diagrams—Package, Requirements, Block Definition, Internal
Block, Activity, State, Sequence, Use Case and Parametric.
3.2. SysML Overview
According to (Friedenthal et al.2009) a clear definition of SysML is provided, stating, “SysML is a general-
purpose graphical modeling language that supports the analysis, specification, design, verification, and
validation for complex systems. SysML attempts to satisfy each of these stated goals through a formal
definition of various diagrams, specifically a requirement diagram, an activity diagram, a sequence diagram,
a state machine diagram, a use case diagram, a block definition diagram, an internal block diagram, a
parametric diagram, and a package diagram. Figure.2 is a taxonomy diagram that more clearly establishes the
intended linkage between these diagrams.
SysML is organized around nine types of diagrams, which the Object Management Group (OMG) has divided
into three main groups (a case study showing the use of some of these diagrams is carried out in the following
section):
• The first group includes four behavioral diagrams:
1. Activity diagram (is used to model behavior in terms of the flow of inputs, outputs, and control)
(Friedenthal et al.2009);
2. State diagram (shows the different states and possible transitions of the dynamic blocks);
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 4
3. Use Case diagram (describes the behavior of a system, specifically the relationship between a system
and actors that impact the operation of that system;
4. Sequence diagram (is particularly useful for defining sequences of message exchanges or trigger
actions between blocks).
•The second group contains a single cross-sectional diagram: the requirements diagram (shows the external
requirements of the system and their relationships).
•The third group includes four structural diagrams:
1. Block definition diagram (shows the basic static building blocks: blocks, compositions,
associations, values, operations, generalizations ...);
2. Internal block diagram (defines the internal structure of a block, typically a physical element
with a focus on the connections between parts of a block);
3. Parametric diagram (represents the constraints of the system, the governing equations);
4. Package diagram (shows the logical organization of the model and the relationships between
packages).
CONTRIBUTIONS
For a long time, system engineers have been using modeling techniques. Among the best known are Structured
Analysis and Design Technique (SADT) and SA / RT, dating from the 1980s, as well as many approaches
based on Petri nets or state machines. (Roques, 2018)
SADT uses a graphical sequence of elementary boxes refined downwardly in other SADT models (boxes +
streams). The models used can be actigrams (the boxes are the functions and the flows are the data) or
datagrams (the boxes are the data and the flows are the transformations).
An example of SADT adapted to Hydrocyclone is presented in Figure.3; non-classified phosphate particles
enter the hydrocyclone, parameter required are Energy, Specified number of cyclone, physical parameters such
as flow control and pression , and we obtain classified particles of phosphate (Overflow and Underflow).
This presentation with SADT, allows a well understanding of the equipment, in our case Hydrocyclone, we
can adapt the same modeling for all equipment of mineral processing.
Figure 2. Actigram SADT example of the hydrocyclone
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To manage data, the data flow diagram shown in Figure.4 for beneficiation activity, we choose the example
of phosphate washing. The process consists on five processes: scrubbing, screening, classification, flotation
and decanting. Data required depends on quality of phosphate that enter the scrubbing operation. For flotation,
reagent dosing represent a critical parameter for good mastering of flotation. The source of phosphate is mine
exploration (ore), and after several processes, we have three different destinations: stockpile, wash concentrate
and tailings thickening.
In this section, we discuss the system implementation. We adopt a decomposition approach of the system into
subsystems to model its configuration.In this decomposition, we must begin by defining the system on which
we will work; in our case, it is mineral activity. Then we have to go into the granularity of the process.
To develop the static model, we can identify different classes and objects, allowing to describe the system.
Those classes are the physical and conceptual entities of the system. In our case, the block definition diagram
of Mineral activity consists of three main blocks: Mine, Beneficiation and Chemical treatment. (Figure.5)
In this work, we focus on Beneficiation activity, for which its block diagram contains the following blocks:
Wash plant, Stockpile and flotation.
The wash plant itself, consists of several processes using different equipment: Scrubber-Screen-Hydrocyclone-
Hydrosizer-Decanter and Crusher.
Figure 3. Data Flow Diagram, example of Phosphate washing
Figure 4. Mineral Activity block definition diagram (bdd)
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This approach establishes a linkage between the system architecture and system analysis domains, based on
SysML architecture. This first physical architecture allows developing more complete system requirements.
After having identified all the blocks to represent the system, the next step is to define the requirements of the
equipment seemed critical in the beneficiation activity. Since physical classification operation is a critical one
in Beneficiation, we propose a requirement definition diagram for the hydrocyclone in (Figure.6)
As a critical equipment in mineral processing, hydrocyclone must be performant, in order to master well what
comes after classification. The shape of discharge must be in form of skirt to prevent the problem of roping,
size of particles in the underflow must be greater than the cut size, as well as the size of overflow, which must
be smaller than the cut size. Other requirement is to ensure an accurate cut size. In mineral activity, in most
cases, a cluster of hydrocyclone is installed in parallel; for each cyclone requirements are the same, just for
the cluster of cyclones, we specified number of cyclone in work and in standby.
The definition of requirements is a main phase to master well the design of new equipment adding the digitized
components, which increases the system complexity. In other words, requirements will be used to define
sensors to implement, operating parameters to respect, and design parameters to use for a well control of the
process during its life cycle.
CONCLUSION AND PERSPECTIVES
In this work, we studied the phosphate beneficiation activity from a complex systems engineering approach
perspective. First, we presented a conceptual model for Phosphate recovery process for one critical equipment,
which is Hydrocyclone. Our adopted approach summarizes various modeling tools working with a well-known
industrial partner in Phosphate valorization. Using these approaches, we will guarantee efficient beneficiation
processes by optimizing their operating parameters. In future works, we will investigate the possibility to apply
complex engineering systems approaches for different parts of global Phosphate processes.
REFERENCES
Birken. I, Bertucci. M, Chappelin. J, Jorda. E, Quantification of Impurities, Including Carbonates Speciation
for Phosphates Beneficiation by Flotation, Procedia Engineering, Vol 138, pp.72-84, 2016.
Friedenthal, Sanford, Alan Moore, and Rick Steiner, A Practical Guide to SysML The Systems Modeling
Language. San Francisco, CA: Morgan Kaufmann, 2009.
Figure 5. Example of requirement diagram: hydrocyclone requirement
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International Council on SE, INCOSE, What is SE, Available: http://www.incose.org/AboutSE/WhatIsSE,
August 23, 2016
Komar Kawatra. S, Carlson.J.T, Beneficiation of phosphate ore, pp.20-22, Electronic edition, 2014.
Lawver .J.E, McClintock.W.O, and Snow.R.E, Beneficiation of phosphate rock a state of the art review,
Minerals Science and Engineering, Vol. 10, No. 4, pp. 278–294,1978.
Sis.H, Chander.S, Reagents used in the flotation of phosphate ores: a critical review, Minerals Engineering,
16, pp. 577-585, 2003.
Somasundaran.P, On the problem of separation of calcite from calcareous apatite. In: 11 th Int. Miner. Process.
Congress, Cagliari. Vol. 2, pp. 155-156, 1975.
Roques.P, Modeling complex systems with SysML, pp.10-65, Eyrolles edition, 2013.
Roques.P, Systems Architecture Modeling with the Arcadia Method, a Practical Guide to Capella, 2018.
BIOGRAPHIES
Mariem Ait Bakader Ph.D. student in Applied Chemistry laboratory at the Faculty of Science and
Technology of FES in the University Sidi Mohammed ben abdellah, and Process Engineer graduated from
National School of Applied Sciences KHOURIBGA. She is also a member of the laboratory research team:
Complex Systems Engineering at Mohammed VI Polytechnic University. Her research fields are Process
Optimization, Phosphate beneficiation, Complex System Engineering.
Laurent Deshayes is currently deputy director of the complex system engineering laboratory at the
Mohammed VI Polytechnic University in Morocco. Mr. Deshayes holds an Engineering Degree in Industrial
Systems from the National Engineering School of Tarbes, France and a PhD Degree in Mechanical Science
from the National Institute of Applied Sciences in Lyon, France. He taught courses in industrial management,
advanced automation, manufacturing execution systems. He is currently developing living labs and research
platforms for mining and chemical processes in order to build strong Moroccan and African competencies in
advanced engineering areas such as System Engineering, Advanced process control, real time scheduling,
industrial digitization and Beneficiation processes.
Mohammed El Asri is currently a fulltime lecturer in Faculty of Sciences and Technology, Sidi Mohamed
Ben Abdellah University. Also is head of Research Team: Macromolecular and Applied Chemistry. Mr. EL
ASRI PhD in Materials Chemistry at Montpellier II University. He supervised several research projects and
PhDs. He has taught courses in polymer and organic chemistry and Thermochemistry and kinetics. He has
also taught optimization and control of industrial process by design of experiment. He coached several
companies on control and optimization from projects by DOE. He is also an expert and trainer with a Saiss
Opex consulting firm.
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THE CAUSAL MODEL OF WORKFORCE’S SKILL
DEVELOPMENT IN THE 21ST CENTURY: NUMERACY
Sunisa Juimoungsri
Sukhothai Thammathirat Open University, Thailand, E-mail: [email protected]
Sajee Jiraro
Sukhothai Thammathirat Open University, Thailand, E-mail: [email protected]
ABSTRACT
Numeracy is a basic skill that will lead to developments in the 21st century. The purpose of this study
was to analyze the causal factors of numeracy development. Data were collected from 2 ,0 0 0 Thai samples
aging 15 - 65 years and analyzed using structural equation modeling. It was found that the factor that had the
most significant and positive effect on the numeracy was achievement motivation to numeracy. The uses of
information technology for communications and learning numeracy were indirectly affected by the
achievement motivation.
Keywords: Numeracy, Numeracy Development
INTRODUCTION
Changes, evolutions and advancements in all aspects in the 21st century (i.e. the age of globalization)
are rapid and drastic. Thus, each country has to set strategies and be prepared for the changes in order to
appropriately improve the skills of their workforces in this century. Since Thailand has variety of people’s
characteristics such as nationality, religion and living; they have different needs for self-developments.
Especially for people aged 15 – 65 years (i.e. working age), these people are the important workforces whose
skills must be improved according to the changes. According to Thailand’s adult skill assessment report in
2014 (Office of the Education Council, 2015), it was found that Thailand needed to quickly develop
foundations for the changes in three aspects including literacy and reading component, numeracy, and problem
solving in technology-rich environment. The developments of the mentioned skills require to understand the
factors leading to the developments in order to gain information for setting strategic plans and policies for the
developments of human capacity for the 21st century, both in terms of human capacity development and the
youth development with formal and informal education. Therefore, this study was conducted in order to
analyze the casual factors of developing the numeracy that is a basic skill for living and developing concepts
and innovations leading to advancements in this century.
Numeracy
The Program for the International Assessment of Adult Competencies (PIAAC) (Office of the
Education Council, 2015) defined numeracy as an ability to access, use, interpret, and communicate
mathematical data and concepts in order to access and handle mathematical needs in situations in adulthood.
Numeracy is an essential skill for adults and societies.
Acheivement Motivations to Numeracy
An achievement motivation is a desire for significant accomplishment. The individual with
achievement motivation will be enduring and consistent concern with setting and meeting high standards of
achievement. The success make them happy, in other words, the failure make them worry (McClelland, 1961
cited in Kotsri, 2004). The achievement motivation is a factor affecting an ability to solve mathematical
problems (Samransuk, 2009; Wangprasert, 2012), mathematical achievement (Jamroenpat, 2009; Jai-Uea,
2012), and mathematical reasoning ability (Udompornmontri, 2012).
Attitudes towards Numeracy
An attitude towards mathematics is an individual’s feeling to respond to mathematics subject
regarding its benefits, importance of contents, and classroom management after experiencing a mathematics
classroom management. The attitude may be positive, neutral or negative. The attitude is a factor affecting an
ability to solve mathematical problems (Wangprasert, 2012), mathematical achievement (Bas and Kuiper,
1999; Schreiber, 2002), mathematical reasoning ability (Udompornmontri, 2012), and numeracy (Member of
the All Numeracy Team, 2002).
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Amsterdam 9
The Uses of Information Technologies for Communicating and Learning Numeracy
The uses of the information technologies significantly develop achievement motivations to numeracy
by delightful learning environment which promote the students’ interest and understanding (Hudson et al.,
2006). The information technologies are similar to vehicles for learning numeracy. Children can apply
mathematical concepts to conduct calculation related activities (Kilderry and et al., 2003). The development
of learning numeracy through ICT efficiently promotes interactions between learners and lessons since the
learners are motivated to learn and be parts of the lessons (Coben et al., 2007).
Supporting Factors
Straesser (2015) mentioned that the numeracy development of working-aged people should be
relevant, appropriate, and integrated to their duties. Parents who have paid their attentions to their children’s
numeracy since the children were young could improve the children’s numeracy (Schreiber, 2002). Family
background (Bas and others, 1900; Kiamanesh, 2002), communications with parents (Bicer and others, 2000),
family supports (e.g. family expectation) (Bicer and others, 2000), and parents’ education (Schreiber, 2002)
are supporting factors of different numeracy levels.
Numeracy Engagements
An engagement in numeracy is a positive feeling to do a task and be a part of it. A longitudinal study
of Warren, Young, and deVries (2008) in young Australian indigenous students’ literacy and numeracy
(YAILN)--collecting learning data and teaching activites that support the students’ learning in Queensland--
found that learning by playing is very important for learning the mathematical basics. Playing with
mathematics develop the students’ engagements in studying the subject, and then led to their learning
developments.
DATA
In this study, the quantitative data were collected from Thai people aged 15 – 65 years working in
agriculture, industry, and service sector across 5 regions of Thailand including the northern part, northeast
part, southern part, Bangkok and vicinity. (400 samples for each region and 2,000 samples in total) using
questionnaires. The qualitative data were also collected using interviews (10-15 samples for each region and
181 samples in total).
METHODS
The review literature were conducted for drafting the hypothetical causal models of the numeracy
development. Then, eighteen Thai education experts were evaluated the draft of hypothetical model. After
the revision of model using the experts’ recommendation was conducted, the research instruments were
developed. Data were quantitatively collected using numeracy test and questionnaires. In-depth interview
was performed to collect the qualitative data.
The consistencies of the developed models and empirical data were analyzed using Structural
Equation Modeling (SEM) via LISREL program. The contents from interview were analyzed using MAXQDA
program. Afterwards, the model was reviewed by 13 education experts. Consequently, conclusions regarding
policies for Thai population’s numeracy development were made.
RESULTS
The result revealed that the hypothetical model of workforce's skill development in the 21st century
model (numeracy) was consistent with the empirical data after constrained the relationships of observed
measurement errors. The model fit indices was shown in Table 1
Table 1: The model fit indices of workforce's skill development in the 21st century model (numeracy)
Model fit indices Criteria Value Conclusion
Chi-square(2) without any
difference
p>0.01 0.10 Accepted
2/df <2.00 1.46 Accepted
GFI >0.95 1.00 Accepted
AGFI >0.95 0.99 Accepted
CFI >0.95 1.00 Accepted
RMSEA <0.05 0.015 Accepted
SRMR <0.05 0.006 Accepted
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Amsterdam 10
By considering the standardized form of direct, indirect, and total effect of the numeracy models as
shown in Figure 2, it was found that the factors that had the greatest positive direct effect on numeracy was
the supporting factors to numeracy (SUP; standardized coefficients equal to 0.86) followed by the attitude
towards numeracy (ATT; standardized coefficients equal to 0.28) which mean that the individuals with
supporting factors to numeracy and attitudes towards numeracy will have high numeracy. Regarding the
indirect effects, it was found that the uses of the information technologies (IT) for communicating and learning
numeracy had indirect effect on MOTIVE (standardized coefficients equal to 0.54). The supporting factors
(SUP) had indirect effect mediated by the numeracy engagement (ENG; standardized coefficients equal to
0.28). The total effect is - 0. 66.
Figure 2: The Causal Relationship Models of Numeracy
By considering the total effect which combined the direct and indirect effects, it was found that the
factors that had the greatest positive effect on numeracy was MOTIVE (0.60) followed by IT (0.54), ATT
(0.28), and ENG (0.32). SUP has the total effect value of -0.66. That is negative effect on numeracy. The
direct, indirect, and total effects of workforce's skill development in the 21st century model (numeracy) was
shown in Table 2
ENG
Learning Power 0.67**
0.72** 0.78** 0.89** 0.86**
0.86**
-0.94** 0.32**
1.00**
0.28**
0.90**
0.90**
0.96**
0.64**
0.60**
0.67**
0.91**
0.60**
0.90** 0.89*
*
0.87**
Family supports
Relevant Experiences
Dedication Unity
SUP
ATT MATH
ACH
MOTIVE IT
Awareness of
Importance
Awareness of
Benefits
Interests
Data Search
Data Transfer
Data
Management
Numeracy
Numeracy goal
Numeracy satisfy
Numeracy perception
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Amsterdam 11
Table 2: Direct, indirect, and total effects of the numeracy skill development (n = 2,000)
** p < .01
Note: DE = Direct effect, IE = Indirect effect, TE = Total effect
CONCLUSION
It could be concluded that the supporting factors to numeracy was a factor that had the greatest
positive effect on numeracy. The uses of information technologies (IT) for communicating and learning
numeracy had indirect effects from the numeracy engagement. On the other hands, the individuals with quite
high numeracy ability as self-report mostly had calculation-related occupations requiring complex, fast and
accurate numeracy as well as computer programs. Some of those evaluated themselves as ones with low
numeracy ability had fair numeracy or no numeracy with frequent calculation errors and without complex
calculation skills.
DISCUSSION
The research found that supporting factors negative direct effect on numeracy. On the other hands, it
has positive indirect effect on numeracy through numeracy engagement. That is, if the numeracy skill is
supported by supporting factors in a sense of numeracy engagement, it will be positive. On the other hands, if
the numeracy skill is supported by direct supporting factors, it will be negative. In line with Straesser (2015),
who commented that the development of numeracy skill should suitable and relevance for work. This will
success to develop the skill. In addition, Bas and Kuiper (1999) argue that family support has resulted in
children numeracy engagement. This leads to higher levels of numeracy skill. If it is direct support, but no
sense of engagement. This will make the person have less ability to numeracy.
ACKNOWLEDGEMENTS
The researcher would like to acknowledge the Institute for The office of the
Education Council of Thailand which funded this research.
REFERENCES
Bas, X. and Kuiper, W. (1999). Modelling TIMSS Data in a European Comparative Perspective: Exploring Influencing. Bicer, A., et al. (2000). The effects of Parent’s SES and Education Level on Student’s Mathematics Achievement: Examining the Mediation Effects of Parental Expectations and Parental Communication. The Online Journal of New Horizons in Education.
Coben, D., et al. (2007). Greater than the sum... Report of the action research project: The Use of ICT in
Adult Numeracy Teaching in Scotland, Phase 2. London. NRDC.
Hudson, C., et al. (2006). Maths4Life: Pathfinder Report. London: NRDC.
Jai-Uea, W. (2012). The Multilevel Structural Equation Models for the Factors of the
Causal
variable
Numeracy Engagement
(ENG)
Numeracy Motivation
(MOTIVE)
Numeracy Skill
(MATHACH)
DE IE TE DE IE TE DE IE TE
IT for
numeracy
development
(IT)
- - - 0.91**
(0.03)
- 0.91**
(0.03)
- 0.54**
(0.13)
0.54**
(0.13)
Support
(SUP)
0.86**
(0.03)
- 0.86**
(0.03)
- - - -0.94**
(0.07)
0.28**
(0.08)
-0.66**
(0.13)
Numeracy
attitude
(ATT)
- - - - - - 0.28**
(0.03)
- 0.28**
(0.03)
Numeracy
Engagement
(ENG)
- - - - - - 0.32**
(0.10)
- 0.32**
(0.10)
Numeracy
Motivation
(MOTIVE)
- - - - - - 0.60**
(0.14)
- 0.60**
(0.14)
R2 0.74 0.84 0.21
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Amsterdam 12
Achievement of Learning Mathematics of the 11th Grade Students of Public Schools in
Ubol Ratchathani Province. Thesis, Master of Education, Mahasarakham University.
(in Thai)
Jamroenpat, S. (2009). The Causal Relationships of the Factors of the Achievement
of Learning Mathematics of the 8th Grade Students in the Secondary Educational Service Area
Office 3, Kalasin Province. Thesis, Master of Education, Mahasarakham University. (in Thai)
Kiamanesh, A.R. (2002). Factors Affecting IRANIAN Students’ Achivement in
Mathematics. Teacher Training University.
Kilderry, A., et al.(2003). ICT and numeracy in the knowledge era creating contexts for
new understandings. Childhood Education. 79(5): 293-298.
Kotsri, M. (2004). The Developments of the Causal Relationship Models for the
Numeracy of High School Students, Master of Education, Burapha University. (in Thai)
Lhaemthong, S. (2009). The Factors of the Numeracy of the 11th Grade Students in
the Northeastern Part of Thailand: the Multi-Group Analysis. Thesis, Master of Education,
Mahasarakham University. (in Thai)
Member of the All Numeracy Team. (2002). Adult numeracy and its assessment in the
All survey: A conceptual framework and pilot results. Adult Literacy and
Lifeskills Survey. Statistics Canada-Ottawa, Qutario K1A0T6, Available online:
www.ets.org/all.
Office of the Education Council. (2015). Thailand’s Adult Skill Assessment 2014.(Copy).
(in Thai)
Schreiber, J.B. (2002). Institutional and Student Factors and Their Influence on Advanced
Mathematics Achievement. The Journal of Educational Research. 95(5): 274-286.
Straesser, R. (2015). Numeracy at work: a discussion of terms and results from empirical
studies. Zdm, 47(4), 665.
Udompornmontri, T. (2012). The Investigations of the Factors of the Mathematical
Rationales of the 7st Grade Students in the Secondary Educational Service Area
Office 5. Thesis, Master of Education, Srinakharinwirot University. (in Thai)
Wangprasert, W. (2012). The Factors of the Numeracy of the 1st Grade Students in the
Secondary Educational Service Area Office 42. Independent Study, Master of Education, Atcharalai
Campus Nakhon Sawan Province. Naresuan University.
(in Thai)
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on four-year-old Indigenous students. Australian journal of early childhood.
33(4): 2-8.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 13
THE ETHNOGRAPHY STUDY OF THE URBAN POOR LIVES IN
THE PUBLIC SPACE
Kumpetch, Jaruwan (Assoc.Prof)
Srinakharinwirot University
Faculty of Social Sciences, Department of Sociology
113 Sukhumvit Road, Bangkok, Thailand
(+66)89-897-1451 Email: [email protected]
ABSTRACT
The study of urban poor lives and the use of public space in this city is aiming to present empirical
information about poor lives who have been using public space as their part of living. The study method is the
participatory observation with some urban poor lives. The interviews are deeply focused on their daily routines
and backgrounds. The area of study is in the center of Bangkok, at Sukhumvit Road between Asok-Sukhumvit
and area around it, where embassy, commercial business company, expensive housing, and department stores
are located. This area can also be referred to the major business area in Bangkok. The study has shown that
world’s population now rather lives in an urban area than a rural area. People who came to Bangkok are
seeking a better life and they have worked here for over 20 years. They either work as an employee, go around
collecting old stuff for resale, sell food on street, or work as general service staffs. The immigrants see
Bangkok as an area of opportunity. It has been designed for convenient and faster lifestyles. However, there
is another side of the town where people are struggling in the midst of the city because Bangkok is not yet to
be a place for everyone who is different in classes. Despite the differences in status, conditions, and occupation,
urban poor lives are trying to survive and have honor humanity.
Keyword Bangkok, urban poor lives, Sukhumvit Road
INTRODUCTION
The study of society and people in the world was originally described as people are identified to live
in rural area and urban area. Until 1996, the percentage of people who live in an urban area has risen up to
over 50 (Clark,1:1995) By the turn of the millennium, it has been found that world’s population has become
more of urban lives than rural lives. With the condition that urban cities have more civilization and grow along
with the modernism, has given the positive thought to people. However, the more growth of the city, the higher
number of urban poor lives. Thai society is one of many countries that are trying to develop itself to an
urbanization. Nonetheless, the city has influenced many aspects of poor urban lives, such as living, traveling,
working, and leisure. The main characteristics of the city are location, economy, and level of development.
Whereas, the lives of poor urban people are limited because of pollution, risks, and environment that interfere
the relationship between lives and city (Jan Gehl,15:2010) Furthermore, Jane Jacobs (1960) published one of
the most important books “The Death and Life of Great American Cities”. He specified that if the city is
mainly focused on traffic transportation, independent building construction, there will be no more public space
and urban lives. Consequently, the city might turn to a lifeless town.
The study of urban poor lives and the use of public space is aiming to present ethical characteristics
of urban poor lives. In Bangkok, one of the most powerful economic area is at Asok-Sukhumvit. With the
facts that Asok-Sukhumvit area is surrounded by commercial companies, that run business activities,
expensive residential buildings, relaxing space at the Asian’s largest shopping mall despite urban poor lives.
This is known as the overlap of utilization in spaces.
Bangkok is first established in the year 1782 with only 4 square kilometers, but right now, there are
increased to 1,568 square kilometers. The continually expanding of the city is going along with the expansion
of new roads that were built to replace the water transportation. The population are original people and
Chinese. Because of the city growth, Sam-peng, the commercial area with Chinese people, has changed to
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 14
make a contract with Western people. Consequently, western people deal more business activities and establish
their own embassy and consulate. Western trade routes along the Chao Phraya River include the Silom and
Ratchawong. The city has expanded to the southeast northeast areas because there are more spaces left than
the others. The southern part of Bangkok is an industrial area because it is closer to a pier and it caught rural
lives to move and work in the area. In the year 1960, Bangkok has grown into an industrial investment. The
area around Yannawa, Thonburi, Prakanong, and Samutprakarn, are used for small industries. In 1970, the
number of lands used for industrial investment has risen. The car industry was invested and the encourage in
travelling that has led some area to become a nightlife area. With the Vietnam War period, many soldiers
traveled to Bangkok and there was an emerge of the area called “Redlight District” at Silom road which is
worldwide known as “Patpong”. This kind of area has continually expanded to the north of Sukhumvit and
soon connected Petchaburi Road where hotels and bars are located along the way. The expansion of Bangkok
area has shown the interaction that “City build people and people build a city”. The ethical urban poor lives
study as Walter Benjamin (1927: 1940) wrote the article “ Arcade Project” which he located city as “text” that
is readable and people in the area all have experiences with the city. In another word, the way people are in
the city is changing accordingly with how the city is created by the reading of people in the city. The
development of the city from traveling by water to road traffic and now is using the railroad traffic. With the
changes, the way of lives and uses of spaces has been affected.
LITERATURE & THEORY
Ethnic description of urban poor lives in the city does not only define as people who have a low-
income, but it also covers people who lack opportunity, honor, and humanity. The poor and immigrants are a
shadow of the urban city. They are gathering together in different areas where the house rental is not expensive
or use the public space and soon form a slum in the city. The urban poor life once said that “The city will not
grow without poor lives” because they are a part who build the city and create the identity of urban poor lives.
The growth of Bangkok is classified as “world cities”. Even though Bangkok has not ranked as core
country, but it is ranked in secondary semi-periphery countries (Clark, 140)
URBAN WORLD / GLOBAL CITY
TABLE 1 Hierarchies of world cities
Core countries Semi – periphery countries
Primary Secondary Primary Secondary
Europe :
London Brussels
Paris Milan
Rotterdam Vienna
Frankfurt Madrid
Zurich
America :
New York Toronto São Paulo Buenos Aires
Chicago Miami Rio de Janero
Los
Angeles
Houston Caracas
San
Francisco
Mexico City
Asia :
Tokyo Sydney Singapore Hong Kong
Taipei
Manila
Bangkok
Seoul
Source: Friedmann (1986) in David Clark (1996:140)
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 15
The city construction of Paris was planned by Haussmann, who develop Paris after the year 1852. He
has planned to build a big road with the very broad range to facilitate civic control by the military and facilitates
the culture of the people who come out to relax and there are coffee shops along 2 sides of the street. Jan Gehl
has mentioned that the building needs to have space between each other so people can interact with one
another. In another word, life between buildings is to do activity together as a part of city’s area. Walking is
the beginning of that. Therefore, the city has to create a good opportunity for walking and also encourage
urban lives. The characteristic of urban lives is diversity and complexity.
Another way to explain relationship between people and area is from Lefbvre (1991:33) He used idea
of Space to explain people’s characteristics from the work called “The production of Space-POS) He classified
areas into firstly, Spatial practices, which describes the area of production, repetition, and set of characteristics
in each form of creation. This will hold people within the area together. Secondly, Representation of space
which associate production relationship with other things. Thirdly, Representational space that is created from
complexity in symbols, time codes, that in some cases are linked to some concealment of social life and art.
The study by using the concept of Space will build a better understanding of representation in the area that is
created from physic, mental, and social (Jaruwan Kumpetch, 2012: 13)
DISCUSSION
The study to describe a characteristic of people living in the different area comes from a classic study
of sociologists that have differentiated areas into rural and urban areas and further to differentiate the
characteristics of people. Ferdinand TÖnnie (1887) has described the social structures into Gemeinschaft and
Gesellschaft. Whereas Talcott Parsons (1967) has described social structures into Modern society and
Traditional society. Nonetheless, Max Weber (1958) has described it as the Capitalist society and traditional
agrarian society. Another sociologist, Emile Durkheim (1893) has described social structures as Mechanic
solidarity and Organic Solidarity. By describing the social structures, rural society’s description is usually
about simplicity and dependent on each other. Whereas the description of urban society is an independent
living, not familiar and disinterested with each other, and trust problems. Those are common characteristics
of urban lives that lie on an individual. The classic work, which is related to study of Bangkok, is written by
Akin Rapeepat (1994) The anthropology of the city. The slum in Bangkok that Akin has significantly and
differently described lives in urban areas from the previous concept that usually concerns city’s problems.
Foucault is another person who used areas to explain the characters of people who are created from the
environment they are living in. He defined that as “Fundamental areas”. In human integrity (1984), Foucault’s
study has presented characteristic of people who live in different areas, such as prison, military hospital, and
the madhouse. He concluded that areas create person’s characters.
The study of urban poor lives in public space. People are using space on the road for commercial
purpose, living, mental happiness, and workplaces. There are several cases we have experienced. First, the
case of Jasmine. Jasmine is working at one of the nightclubs on Sukhumvit road. Jasmine is transgender who
moved to Bangkok in 1986. Her hometown is in the northeastern part of Thailand. She finished high school
and has been working since then. She has been working for over 30 years in different bars. The positions she
has taken before are receptionist and cashier. Currently, Jasmine is working as a manager. She starts working
in the afternoon, walking from her rented room. Then she will open the place and work as one of the employees
during night time. Jasmine works as a translator since most of the customers are foreigners. Due to her
workplace and position, she has learned many languages to understand and attract customers. The interaction
between Jasmine and her co-workers is going smoothly because they are the same which is defined that they
are under the same conditions of culture and economy. For instance, divorce with husband or wife, taking care
of children or parents alone. This will guarantee the survival in the city.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 16
The atmosphere and people at night in soi cowboy.
The second case is the girl named Kate. Kate is like a bloomed flower in the area for over 20 years.
However, she married a foreigner, whom she met at the bar. Kate came from the northern part of Thailand.
She has a beautiful face. She finished high school, got married, and had children later on. The Sukhumvit area
has changed her life. She got accepted from people in the area despite the divorce. She donated her money for
building a temple. However, at one stage, Kate has to get medical care from madhouse because she has a nerve
problem. Kate works as hostess with no monthly salary. Due to that, she has to promote herself to a customer
by massaging. She expected the customers to buy her a drink. Kate lived in her workplace for over 20 years.
She has been under stress because of the responsibilities she has to handle. Her health get worse because she
has to drink with customers every night, as well as her mental health. Kate once wore white clothes, like
Buddhist nan, to work. Later on, she was sent to the hospital to get health care. Within the area where bars are
located, it is where competition to gain advantages starts. Kate didn’t go back to work because of her sickness.
According to Mary L. Grow, he studied about a group of people who work as a joker. He found that this group
of people had to perform ceremony based on their belief. This is similar to Kate’s case. Kate turned her head
to meditation ritual as one of the recoveries. This action has shown the confliction in urban lifestyle. At Asoke
road, the most important commercial area, is a location of Ardhamariswara, according to Hindu belief.
Workers in the area come to this place to pray for what they want or ask for help. Kate is one of many people
who go to pray Ardhamariswara.
The blessing in the urban area at Sukuvit Rd.
The third case is about a hawker named Chai. Chai sells one of Thai food at Ratchadapisek Road
since he was young. Now, he is 90 years old but still sells Thai food. Chai said that he was from the middle
part of Thailand but moved in to Bangkok to work at the port when high number of people were needed. He
rented a house near Khongtoei Pier and have lived there since then. Chai said that “When I first came here,
Rama 4 Road has not been built. There were no cars and no Ratchadapisek Road. Even though there is road,
it is not as board as it is now. Khongtoey market is not as big as it is nowadays. Money left from selling is not
much. After I moved to Bangkok for over 60 years, I have seen so many changes”
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 17
Street vendor at Khlong Toei market
The fourth case, Paul is a homeless guy. He used space in front of 7&11 convenience store as a home
for over 10 years. In the afternoon, Paul stays at the park closed to an area. In the night, Paul comes back to
sleep at 7&11. Since Paul has left hometown for over 40 years and he has not planned to go back because there
is no one left. He said that he lived a freedom of life as a homeless. The place in front of a convenience store
is safe because the light is turned on the whole time. He doesn’t see any problems with living on the street
because he doesn’t have enough money to pay the rental fee. Using public space is suitable for city life.
Homeless people in Bangkok
To study about this, the qualitative method is used. The participatory observation with the area around
Asoke and Sukhumvit road of over 2 kilometers. Moreover, the small street between Sukhumvit 21 and
Sukhumvit 23, which is called Soi Prasarnmit, is where Soi Cowboy located. Nonetheless, a place in front of
Emporium The EmDistrict was also observed. We have worked 24 hours for a month to collect the useful and
accurate information. We also did an in-depth interview with urban poor lives who use public space for living,
working, and leisure. To analyze the concept of space and urbanization
RESULTS
The study found that urban poor lives have a different form of living according to their economic
conditions and individual’s society. Everyone has moved to Bangkok for over 20 years. Some of them has
changed job to a higher salary rate. Some decided to live a free life of hawker. Some used public space as a
home. All the public space created the interaction within society. In an urban area, there are several types of
people. Those people provide what white-collar workers, who work in a high-rise office building, need such
as food or stuff.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 18
The street food for office worker. Motorbike hire in the rush hour of the city.
CONCLUSION
The development of the city, immigrants moved into the urban areas because they were looking for
a better life quality. People adapted themselves to a change of the city from 150 years ago. Many high-rise
buildings, that have taken space around the world, have changed the landscape of the city. This has influenced
urban poor lives just like what Jasmine, Kate, Chai, and Paul have faced. The study of the city from George
Simmel (1858-1918), he wrote a story of “The Metropolis and Mental Life (1930:103) explained about the
relationship between mental and psychic life. He stated that the city has an influence on lives in the city. Even
though Kate was sick, people didn’t contact her that much because they believe it’s not related to them. Urban
lives believe in “Freedom to be different is possible”. George explained about individual lives in the city and
the status of the modern city as a currency has more impacts. Moreover, the freedom of the individual in the
city has changed from the past. Chai might get to talk with the customer but it is only for a short period of
time. Paul might also get to talk with another homeless but no one will go deeply in details about another’s
life. This is because there are differences in urban lives, including culture, social structure, gender, and
education. We can also refer this as a subculture of an individual (Monti and all, 2015:86).
REFERENCES
Benjamin, W., Eiland, H., & McLaughlin, K (2003), “The Arcades Project” .Cambridge, Mass: Harvard
University Press.
Clark, D (1996), “Urban world/global city”, London: Rutledge.
Gehl, J (2010), “Cities for People”, Washington, DC: Island Press.
Jacobs, J (1961), “The death and life of great American cities”, New York: Random House.
Kumpetch, J (2012), “Urban space and everyday life in Soi Cowboy, Sukhumvit 23, Bangkok
Metropolitan”, (Doctor of Fine Arts & Culture Research Ph.D.), Srinakharinwirot University,
Bangkok.
Kumpetch, J. (2012). “The Urban Life”, International Journal of Behavioral Science: 4 Vol.1 (January
2012) pp.37-52
Monti, D. J.(2015), “Urban people and places : the sociology of cities, suburbs, and towns”, Los Angeles,
LA: SAGE.
Rapeephat, Akin. “The Social in Community”, Bangkok. Sririndhorn Anthropology Center.
Rossi, U (2017), “Cities in Global Capitalism”, Cambridge, UK: Polity Press.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 19
EFFECTIVENESS OF SELF-HELP GROUP PROGRAM FOR IMPROVING
SELF-CARE BEHAVIOR AMONG TYPE 2 DIABETIC PATIENTS RECEIVING
SERVICES AT SUB-DISDRICT HEALTH PROMOTION HOSPITALS IN
BANGKONTHEE DISTRICT, SAMUT SONGKRAM PROVINCE, THAILAND
Wanich Suksathan*, Boonsri Kittichottipanich**, Thipapan Sungkhapong***
& Kantapong Prabsangob****
*,**,***College of Nursing and Health, Suan Sunandha Rajabhat University, Thailand1
****College of Allied Health Science, Suan Sunandha Rajabhat University, Thailand
E-mail: *[email protected], **[email protected], ***[email protected], ****[email protected]
ABSTRACT
Based on the concept of social cognitive theory, a Self-Help Group program was designed for type 2
diabetic patients in community based-care.
This quasi-experimental research was to evaluate the effectiveness of the Self-Help Group program
for improving self- care behavior among Type 2 diabetic patients receiving services at sub- district health
promotion hospitals in Bangkonthee district, Samut Songkram province, Thailand.
The sample of this study was 70 participants, aged 50 – 80 years, were purposively assigned to the intervention
groups (n = 35 patients receiving services from Jormploug sub-district health promotion hospital) and the control
group (n = 35 patients receiving services from Bang Prom and Bang Yeerong sub-district health promotion
hospitals) . A questionnaire for socio-demographic characteristics and self-care behaviors was used for data
collecting. Descriptive statistic, Independent and Paired t- test: Baseline and 3 months were used for data
analysis.
The results of the study revealed that the intervention group showed higher self-care behavior than before the
intervention and higher than comparison group (p < 0.05). The finding showed the significant improvement in self-
care behavior. It was concluded that the self-help group program could enable diabetic patients to enhance their self-
care behavior to control their blood sugar.
Keywords: Diabetes, Self-care behavior, Self-help group.
INTRODUCTION
Diabetes mellitus or diabetes is one of chronic diseases and causes death to numbers of patients
around the world. In 2013, an approximately 382 million people are estimated to have diabetes and 316 million
people are living with impaired glucose tolerance [1]. The number of people with diabetes is increasing in every
country. For Thailand, according to Ministry of Public Health (Thailand), Chronic Disease Surveillance Report
of 2010, there were 888,580 diabetic patients in Thailand. The ratio of diabetic illness from the report was
1,395 patients per 100,000 populations. This made it ranked as the second top of non-communicable diseases,
of which the first top belonged to high blood pressure. Diabetes is due to abnormal insulin production or the
effect of insulin that has an impact on high blood sugar or glucose level. According to pathology, diabetes can
be classified into four types; type I, type II, gestational diabetes (found during pregnancy), and other types [2].
Type II diabetes mellitus is caused by the combination of abnormal insulin secretion of beta cells and the effect
of insulin resistance .A person with diabetes may have either result from those mentioned causes greater than
one another .Despite diabetes is a chronic disease, it is treatable through dietary control, physical exercises,
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 20
and oral medicine .The patients who have long term diabetes, their beta cells may gradually be destructed and
fail to control the blood sugar or glucose level .Insulin medication, such as insulin injection, is needed to help
control the glucose level instead of the cells' production itself .Type II diabetes is mostly found in people aged
over 40 years .Risk factors of this type are older age, overweight, lack of physical exercises, and genetics. The
patients with long term diabetes and poor blood sugar control will easily develop complications that cause
illness and death . Complications in diabetic patients may be found when the persons are first diagnosed of
diabetes .Those people may have diabetes without any symptoms. The goal of treatment in diabetes is to
control blood sugar to normal or close to normal level as much as possible .So fasting blood glucose level after
8-12 hours must be 90-130 mg/dl, or the level of hemoglobin A1c (HbA1c) is less than 7 %[2].
Diabetes is a chronic disease .The patients must see their doctors regularly for health check up,
picking up some medicine, and taking doctors' advice .While examining, the patients must inform symptoms
and health problems related to their diabetic illness .The doctor will provide recommendation of how to take
better care of themselves, and how to control blood sugar to normal level; prescribe medicine; and explain
how to take medicine correctly .In order to make patients understand and follow doctors' advice correctly,
communication between patients and doctors must be effective. The important components to improve mutual
and better understanding are language usage in communication and point of views on the topic discussing .
Both patients and doctors must understand what the other try to communicate and what the other perceive on
the subject they are discussing .When the patients do not understand health information or have low health
literacy, they will not follow doctors' direction .Low health literacy and abandoning doctors' advice or direction
are obstacles prevent them from good health . In addition, prior study found that health literacy had association
with self-care behavior among Type 2 diabetic patient [3].
A major aim in the management of diabetes is to decrease the risk of long term complications such
as circulatory problems, renal failure, blindness, and peripheral neuropathy [4] Stabilizing and reducing high
blood glucose levels can reduce the occurrence of such complications. To maintain blood glucose levels in a
normal range, individuals with diabetes are advised to follow a complex management regimen typically
consisting of: blood glucose testing several times daily, daily administration of insulin or medication, careful
regulation of the timing and content of diet, and regular exercise.
Self- care behavior, a key concept in health promotion, refers to decisions and actions that an
individual can take to cope with a health problem or to improve his or her health [5]. There are four dimensions
of self- care including physical dimension, prevented complication dimension, treatment dimension, and
psychosocial dimension [ 6] . Self- care behavior requires motivational and self- regulatory skills. Self- care
management operates through a set of psychological sub-functions. People have to learn to monitor their health
behavior and the circumstances under which it occurs, and how to use proximal goals to motivate themselves
and guide their behavior. They also need to learn how to create incentives for themselves and to enlist social
support to sustain their efforts. Lack of social support, particularly from friends and family, is also considered
a barrier to treatment adherence and self-care, while high levels of support are related to better long-term self-
care management, health outcomes, and glucose control [ 7] [ 8] . In traditional society, family and friends
provided social support. In modern industrial society, however, family and community ties are often disrupted
due to mobility and other social changes. Thus, people often choose to join with others who share mutual
interests and concerns.
Self-help groups, also known as mutual help, mutual aid, or support groups, are groups of people who
provide mutual support for each other [9]. In a self-help group, the members share a common problem, often a
common disease or addiction. Their mutual goal is to help each other to deal with, if possible to heal or to
recover from, this problem. In self- help groups, specific modes of social support emerge. Through self-
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 21
disclosure, members share their stories, stresses, feelings, issues, and recoveries. They learn that they are not
alone; they are not the only ones facing the problem.
Participatory action research ( PAR) , a research method wherein the investigator and participants
collaborate, espouses the value of emancipation and empowerment to help identify and explore constraints affecting participants’ lives, as well as to brainstorm about ways to overcome such barriers.[10] The key features
of PAR are to: plan for change; initiate action for change; observe processes and consequences of change;
reflect on the processes and consequences; revise the plan; and, continue in the cycle.[10]
Since the overall purpose of self-help groups is to afford mutual assistance in accomplishing set
goals,[11] such groups have been considered forms of PAR that can help disadvantaged individuals learn ways
to overcome their circumstances and improve their lives.[5] Evidence suggests self-help groups empower older
people with diabetes to better manage their disease through mutual sharing of illness-related information and
experiences.[12] Similarly, the emotional support generated, within self-help groups, has been found to reduce
stress, anxiety, depression and feelings of isolation,[13] as well as increase one’s perceived confidence or
efficacy related to undertaking self-care activities.[14]
Therefore, the overall aim of this study was to gain a better understanding of the process and
perceived benefits for Type 2 diabetic patients receiving services at sub-district health promotion hospitals,
participating in a self-help group program. The objective of this quasi-experimental research was to evaluate
the effectiveness of the Self-Help Group program for improving self-care behavior among Type 2 diabetic
patients receiving services at sub-district health promotion hospitals in Bangkonthee district, Samut Songkram
province, Thailand.
METHODOLOGY
A Self- Help Group program was developed by using participatory action research. This method
involved the use of both qualitative and quantitative methods. Qualitative data were collected though self-help
group discussions and observations, while quantitative data were obtained, at before and after intervention,
via questionnaires regarding socio-demographic characteristics and self-care behavior. The PAR process, in
this study, involved 5-interactive stages: a) planning; b) action; c) observation; d) reflection; and, e) revising the
plan.[14] The researcher and participants worked collaboratively, throughout each of these stages.
The sample of this study was 70 participants, aged 50 – 80 years, were purposively assigned to the
intervention groups (n = 35 patients receiving services from Jormploug sub-district health promotion hospital)
and the control group (n = 35 patients receiving services from Bang Prom and Bang Yeerong sub-district health
promotion hospitals) . The Self-Help Group program was applied to the intervention groups for three months,
while a regular health promotion program was applied to the control group. A questionnaire for socio-
demographic characteristics and self-care behaviors was used for data collecting at baseline and 3 months. Self-
care behaviors were assessed using four point likert scale questions adapted from a self-care management
questionnaire. Descriptive statistic, Independent and Paired t- test: Baseline and 3 months were used for data
analysis.
Ethical approval was attained from the Suan Sunandha Rajabhat University Institutional Review
Board on human rights, prior to commencing the study.
RESULT
Qualitative findings: All participants expressed satisfaction with participating in the Self-Help Group
program. During the group’ s activities, feelings, experiences and recommendations, related to managing
diabetes were noted. The social support received from the group appeared to enhance acceptance of diabetes
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 22
and understanding the need for self-care diabetes management. Joining the program appeared to enhance the
participants’ confidence in control their diabetes.
Quantitative findings: The majority of the participants were female, aged 50-76 years old. Most
participants were diagnosed with DM more than one year (ranged 1- 20 years) prior to interviewing. Most of
them were not able to control their blood sugar (HbA1c > 7.0). There was no significant difference between the
socio-demographic characteristics regarding gender, age, duration of DM, and blood sugar of intervention and
control groups. Also, as noted in Table 1, before applying the Self-Help Group program, self-care behavior of
intervention and control groups was not significantly different. After 3 months of applying the program, self-
care behavior of intervention group was significantly increased, compared to their self-care behavior score
prior to participating in the program, as noted in Table 2. On the other hand, self-care behavior of control group
was not significantly increased, as noted in Table 3. In addition, after 3 month participation in the Self-Help
Group program, self-care behavior of intervention group was significantly higher than the control group, as
note in Table 4.
Table 1
Self-care behavior mean score of intervention and control groups at baseline
Group N Mean S.D. Sig.
Intervention group 35 3.43 0.369 0.256
Control group 35 3.33 0.339
Table 2
Self-care behavior mean score of intervention group before and after 3 month participation in the Self-Help
Group program
Time N Mean S.D. Sig.
Baseline 35 3.43 0.369 0.00**
After 3 months 35 3.64 0.320
** Difference is significant at the 0.01 level (p < 0.01)
Table 3
Self-care behavior mean score of control group before and after 3 month participation in the regular health
promotion program
Time N Mean S.D. Sig.
Baseline 35 3.33 0.339 0.904
After 3 months 35 3.34 0.338
Table 4
Self-care behavior mean score of intervention and control groups after 3 month participation in the programs
Group N Mean S.D. Sig.
Intervention group 35 3.64 0.320 0.00**
Control group 35 3.34 0.338
** Difference is significant at the 0.01 level (p < 0.01)
DISCUSSION AND CONCLUSION
Using the Self-Help Group program, as a form of mutual aid, aligned well with Participatory action
research in that participants worked together to share information and experiences to overcome their self-care
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 23
barriers. The program help enhance participants’ self-care capacity as the finding showed the significant improvement
in self-care behavior. This finding is consistent with prior studies wherein self-help groups have been found to
enhance self-care behaviors. [6],[13],[15],[16] [17] It was concluded that the self-help group program could enable
diabetic patients receiving services at sub-district health promotion hospitals in Bangkonthee district, Samut
Songkram province, Thailand to enhance their self-care behavior to control their blood sugar.
Limitation of this study was that the majority of participants were females, thus, perceptions about
positive changes in self-care behavior were likely to be derived, primarily, from a female viewpoint. Future
studies need to consider developing and assessing the effectiveness of self-help group programs that include
more male participants and also implement the program in other areas of Thailand.
ACKNOWLEDGEMENTS
The Author would like to thank the Research and Development Institute, Suan Sunandha Rajabhat
University, Bangkok, Thailand for financial support.
REFERENCES
[1] International Diabetes Federation. Diabetes: Facts and figures. Retrieved November 17, 2013 from
http://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures
[2] American Diabetes Association. (2007) Nutrition recommendation and interventions for diabetes
2006: a position statement of the American Diabetes Association. American Diabetes
Association. Annual review of Diabetes. p 132-149.
[3] Kantapong Prabsangob. (2016). Relationships of Health Literacy Diabetes Knowledge and Social
Support to Self-Care Behavior among Type 2 Diabetic Patients. International Journal of Health
and Medical Sciences. 2:3. p 68- 72.
[4] Goodall, Tracy A.& Halfrod, W. Kim. (1997). Diet and Diabetes (I): Assessing Dietary Self-Care in
Patients with Insulin Dependent Diabetes. Psychology and Health,12, 183-195.
[5] Ari ATB.(2002). Dimensions and predictions of professional involvement in self-help groups: A
view from within. Health Soc Work. 27(2): 95-103.
[6] Assuk T. (2001) . The effectiveness of community self-help group on the development of health
behavior among type 2 diabetic patients [thesis]. Bangkok, Thailand: Mahidol Univ.
[7] Glasgow, Russell E., Toobert, Deborah J., & Gillette, Cynthia D. (2001). Psychosocial Barriers to
Diabetes Self-Management and Quality of Life. Diabetes Spectrum,14(1), 33-41.
[8] Glasgow, Russell E., Strycker, Lisa A., Toobert, Deborah J., & Eakin, Elizabeth. (2000). A Social-
Ecologic Approach to Assessing Support for Disease Self-Management:The Chronic Illness
Resources Survey. Journal of Behavioral Medicine, 23(6),559-583.
[ 9] Kate S. Ahmadi. ( 2017) . What is a Self- help group. Reteived August 15, 2017 from
https://psychcentral.com/lib/what-is-a-self-help-group/
[10] Denzin NK, Lincoln YS. (2000). Handbook of qualitative research.2nd ed, Thousand Oaks (CA):
Sage.
[11] Hellerich G. (2001). Self-help versions and practices in Germany.Psychiatr Rehabil J. 25(1): 81-5.
[12] DeCoster VA, George L. (2005) . An empowerment approach for elders living with diabetes: A
pilot study of a communitybased self-help group- -the diabetes club. Educ Gerontol. 31(9) : 699-
713.
[13] Maxwell AE, Hunt IF, Bush MA.(1992). Effect of a social support group, as an adjunct to diabetes
training, on metabolic control and psychosocial outcomes. Diabetes Educ. 1992;18(4): 303-9.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 24
[ 14] Garrett N, Hageman CM, Sibley SD, Davern M, Berger M, Brunzell C, et al. ( 2005) . The
effectiveness of an interactive small group diabetes intervention in improving knowledge, feeling of control, and behavior. Health Promot Pract. 6(3): 320-8.
[15] Kotani K, Sakane N. (2004) . Effects of a self-help group for diabetes care in long- term patients
with type 2 diabetes mellitus: An experience in a Japanese rural community. Aust J Rural Health.
12(6): 251-2.
[16] Lertprapai K. (1996) . The effectiveness of participation in self-help group on self-care deficit in
patients with non- insulin dependent diabetes mellitus at Samutprakan Hospital,Samutprakan
Province [thesis]. Bangkok, Thailand: Mahidol Univ.
[ 17] Arissara Sukwatjanee, Kanaungnit Pongthavornkamol, Gail Low, Nantawon Suwonnaroop,
WanpenPinyopasakul, and Surachai Chokkhanchitchai. (2011). Benefits of a Self-Help Group for
Rural Thai Elders with Type-2 Diabetes. Pacific Rim Int J Nurs Res. 15(3) 220 – 233.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 25
FIRE CONFINEMENT, POSTPARTUM CARE IN THAL
TRADITIONAL MEDICINE
Pongsak Jaroenngarmsamer*, Pradapet Krutchangthong**& Wannee Promdao***
*Pongsak Jaroenngarmsamer, M.D.(Ob-Gyn), M.B.A., College of Allied Health Sciences, Suan Sunandha
Rajabhat University, Thailand, E-mail: [email protected]
**Pradapet Krutchangthong, M.Sc., College of Allied Health Sciences, Suan Sunandha Rajabhat University,
Thailand, E-mail: [email protected]
*** Wannee Promdao, B.ATM, M.Sc., College of Allied Health Sciences, Suan Sunandha Rajabhat
University, Thailand, E-mail: [email protected]
ABSTRACT
Postpartum care is the period of recovery from childbirth. Psychological and physiological change
need to be supported. The uterine involution and lochia need time to change. The pregnant can return her
physiologic change to normal as before pregnant within 6 weeks. Thai traditional medicine has a procedure
called fire confinement or “YU FAI”. This procedure has its principle of high temperature and herbal effect.
It can be explain many benefits to the postpartum mother in 5PRIK such as quick recovery, promote wound
healing and uterine involution, prevent uterine infection, shortening of lochia period, increase breast milk
production, burning fat, muscle relaxation and reduce muscle ache, increase circulation and body wind flow,
maintain body balance and keep the body warm. However, the procedure is complicated and difficult to be
arranged in modern life. Many modifications are introduced with difference effect. Tent is the most
appropriate modification that remains the major efficiency of the conventional one. This procedure can be
easily performed in modern city life. This Thai traditional procedure can be supported its efficacy by scientific
explanation.
Keywords: fire confinement, postpartum care, Thai traditional medicine
INTRODUCTION
Postpartum is defined as the period after childbirth. It is the tired period of mother for breast feeding
and the recovery time after a long period of pregnancy and delivery. Emotional and psychological affect is
starting as postpartum depression, anxiety about her child, her family and herself. Physiological change during
pregnancy is finished and starting to recover. In recent medical practice, medical personal may have major
roles in the phase of immediate postpartum or during admission. However, after the mother being discharged,
the family will take this position. Postpartum mother should have psychological support from her family,
especially her husband. Physiological change will be depend on natural way only.
In Thai traditional medicine, both psychological and physiological change are important. It was
practiced for long time as in the record of the history that postpartum mother should have one procedure to
assist this recovery period. We call YU-FAI as fire confinement procedure.
POSTPARTUM
As mentioned above, the psychological change needs to be supported by the family members. After
tired time, the mother may have many concerns about her baby, how to feed, how he or her grow up, what will
be going on in the future, etc. The worry about family may be the cost of living and job. The nearest concerning
is herself, how she looked like, the possibility to return normal in function and body image, etc.
The physiologic change during pregnancy are the main concern. Weight gain during normal
pregnancy should be 12-15 kgs. Some mother has more but only few mother has less gain. Immediate after
delivery, the baby’s weight, placenta and amniotic fluid should be around 5 kgs. The remaining should be in
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 26
concern to get them out. Most of the mother plan to do exercise after 3 months postpartum. However, should
they wait?
Uterine enlargement during immediate postpartum will become gradually involution. Lochia in the
first 3 days is red, called lochia rubra. Then it turn pink or paler as lochia serosa for next 1-2 weeks. Finally
the color become clear as serum without blood, called lochia alba. The whole process of normal physiologic
return to normal as before pregnant may take 6 weeks.
POSTPARTUM CARE IN THAI TRADITIONAL MEDICINE
The concept of Thai traditional medicine in postpartum period is to support the mother in both
psychological and physiological aspect. The postpartum mother should not be neglected. The family member
or the therapist should have their role in the period. Fire confinement or “YU FAI” is one of the procedure
promoting the healing process. It can be started within a week of postpartum in normal vaginal delivery or
natural childbirth. But it should be delayed to over a month in Caesarean delivery, waiting for the healing of
the operative wound and preventing wound infection. Duration to continue the procedure may be short as
only 7 days or up to 3 months depends on the therapist and the mother. However, the daily procedure cannot
be done over 30 days consecutively.
It is classified in Thai traditional medicine that the fire confinement is one of the therapy in
postpartum period. The benefit of the procedure are as 5PRIK.
1. Promote mother to have quick recovery from childbirth to her normal physiology before pregnant.
2. Promote healing process of the episiotomy wound, involution of the uterus and closing of cervix that
prevent ascending uterine infection and vaginal discharge.
3. Promote flow of lochia in early phase and shortening the whole lochia period.
4. Promote burning of fat accumulated during pregnancy and clear skin.
5. Promote breast milk production.
6. Relax muscle and tendon being pressed by the uterus during pregnancy to reduce muscle ache and
back pain. This is not only in postpartum period but aimed for the future pain in elder, too.
7. Increase circulation and wind flow of the body to maintain the body’s elements balance.
8. Keep body warm, prevent chill from anemia after blood lost during childbirth.
FIRE CONFINEMENT
The postpartum mother is not allow shampooing or showering since it is too cold and in the opposite
way of fire. She needs to clear her skin with warm water prior to the procedure. She will stay on the large
wooden board, like a bed, over the beneath 3 stoves. The stoves are lying in the line beneath her shoulder,
abdomen and legs. The big sink plate is lying as the buffer of fire flame over the stove, not to burn the wooden
board and functioned as the hot plate to distribute the temperature. It looks like to grill the mother. The
charcoal in the stove is made of tamarind wood since it has fewer blisters broken out with constant flame. The
mother on the wood board needs to turn her body side by side. This is the delicate procedure to prevent
burning on her skin. She needs to drink enough warm herbal water during the procedure to prevent dehydration
from heat. In some part of Thailand, the method had been modified by putting fire around the mother, not
directly beneath. It has less temperature and less suffer to the mother. This is more popular than the grill type
as above.
The postpartum mothers who lives in modern city may have difficulty to fine the place for fire
confinement. They applied the traditional fire confinement into shortcut. Many modifications are introduced
as follow.
Hot water bag, putting boiled water in the temperature durable container. The container is putting on
the uterine area of lower abdomen. It is convenience and suitable for the local effect of warm compression.
The higher temperature increase blood circulation of the uterus, promote healing and involution. It is believed
that the temperature making the lochia dry. However, it is only the local effect and cannot replace the whole
process of conventional fire confinement.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 27
Aluminum box, the commercial fire confinement belts in the market. The box is made of aluminum,
filled and refillable with herbal charcoals. The charcoal needs to be lit but without flame. The box then covered
with the thick cloth belt. The belt is putting around the waist with the aluminum box at the front on the position
of the uterus. The effect of warm compression is similar to the hot water bag. However, the burning herbs
provide additional aromatic effect to the mother for relaxing and sleeping. This box is also effect on local area
and cannot replace the conventional fire confinement.
The herbal ball compression is another modification of conventional fire confinement. The ball is
composed of many fresh or dried herbs. It needs to make the ball warm prior to compress on the specific area
by the therapist. The mother feels relax as the pressure on the muscle may feel like Thai traditional massage.
The temperature of the ball increases local circulation and relax the muscles. The symptoms of superficial
muscle ache are relieved but the depth of the temperature by this method may not enough to reach the uterus,
so the effect on the uterus may less. The total efficacy of this herbal ball is depend on many factors as type of
the herbs, temperature and the most important is the therapist. The wrong pressing position may cause no
relaxing effect.
Salt pot compression is the old style one. It remains using in the rural area of Thailand. The big
granule of salt (not salt powder) is put in the clay pot. The pot is heated then put on the mother’s lower
abdomen. The leaf of lucid is placed between the pot and the skin. The effect of the salt is unclear except
temperature keeping. The main effect should be the leaf of lucid that reduces pain. There are some
modification of salt pot. The using the hot brick is an example. However, this method is not recommended
because of burning area on the skin and the therapeutic result is unclear.
Tent is the most popular modification of fire confinement in the city. It is classified as a main
replacement of the conventional one. The mother is sitting in the tent, covered the whole body below the neck.
Her face is not exposed in the high temperature. The source of heat is the electrical cooking pot, filled with
boiling herbs. It is putting in the tent. Most of the herbs are vapored such as bergamot, lemon grass, camphor,
Borneo camper, shallot, turmeric, citrus leaf, etc. The high temperature inside the tent will open the sweat
glands, like sauna. The vapor of boiling herbs will have their effect to clean the waste from the skin and
replace with freshness. The mother can have the whole body treatment without suffer from too high
temperature of fire and more effective effect of herbs in limited space. The recommendation to stay in the
herbal tent is only15 min.
The possible benefit of fire confinement can be explained scientifically as follow;
1. The high temperature causes sweating. It opens the sweat gland and push the debris out. Obstruction
of the gland and the debris can be cleared by sweating, too.
2. The high temperature causes vasodilatation and increases circulation. Good blood flow can promote
wound healing and prevent infection.
3. The high temperature relaxes the muscle and reduce muscle ache.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 28
PRECAUTION
Since the procedure is dealing with heat and high temperature on tired postpartum mother. The
possible of dehydration and burning injury should be aware. There are many believed contraindications such
as toxic food related, cold water contamination and many restriction. However, scientific prove will be needed.
CONCLUSION
Postpartum period needs specific maternal care. Both psychological and physiological support are
important. Fire confinement in Thai traditional medicine is one of the procedure with scientific explanation.
It is less harm to the mother but assisting physiologic change in postpartum. The modifications of the
procedure can be applied in modern life. However, it needs further study for the direct effect and more
efficiency outcome.
ACKNOWLEDGEMENT
I would like to thank you the Research Institute, Suan Sunandha Rajabhat University, Thailand, for
supporting this paper and presentation.
REFERENCE
1. Choompol P. History of Thai Traditional Medicine: The Study from Recipes. Bangkok, Odeon Store
Publishing, 2011. (local language)
2. Indaraprasert S. Postpartum Fire Confinement and Herbal Bath, Is it necessary? In Manual of
Pregnancy and Childbirth, 29th ed. (local language)
3. Institute of Thai Traditional Medicine, Ministry of Public Health. Manual of Maternal Care in Thai
Traditional Medicine. (local language).
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 29
4. Jaroenngarmsamer P and Promdao W. Muttakit, Vaginal discharge in Thai Traditional Medicine. In
Proceedings of 81th the IIER International Conference Saint Petersburg, Russia. 2016.
5. Jaroenngarmsamer P. Water Birth, the Modified Natural Child Birth. In Proceedings of International
Business Economic Tourism Sciences Technology Humanity Social Sciences and Education
Research Conference Milan, Italy. 2016.
6. Khunnithessukkij. Aryuravej Suksa. Bangkok, Promjak Publishing, 1973. (local language)
7. Medical Science Research Institute, Chulalongkorn University. Sithikariya. Bangkok, Chulalongkorn
University Publishing, 2005. (local language)
8. Prapojpetrakaj, Ratchaneechanked and Jirapornlimpananonth. Integrated Thai Traditional Medicine:
Situation of Thai Traditional Medical Service. Bangkok, U-Sa Publishing, 2007. (local language)
9. Promdao W. Herbal treatment, Suan Sunandha Palace Recipes. International Scientific and Ecadamic
forum. 2015 Jun 6;1(6):391-400.
10. Schneider A and Breitner S. Temperature effects on health - current findings and future
implications. EBioMedicine. 2016 Apr; 6: 29–30. Published online 2016 Apr 7.
11. The Foundation of Thai Traditional Medicine Recovery and Promotion, Aryuravej College (Shevok
Komalapat). The Textbook of Thai Traditional Medicine, Phatsart Songkhro, Developing Version,
Book 1. 2nd ed., Bangkok, Dansutha Publishing, 2011. (local language)
12. The Foundation of Thai Traditional Medicine Recovery and Promotion, Aryuravej College (Shevok
Komalapat). The Textbook of Thai Traditional Medicine, Phatsart Songkhro, Developing Version,
Book 2. 4th ed., Bangkok, U-Sa Publishing, 2012. (local language)
13. Thai Traditional Medicine Institute, Faculty of Medicine Siriraj Hospital, Mahidol University. Thai
Traditional Medicine and the Sustainable Development of Thai Traditional Medicine. Bangkok,
Supavish Publishing, 2012. (local language)
14. The Foundation of Thai Traditional Medicine Recovery and Promotion, Aryuravej College (Shevok
Komalapat). The Textbook of Thai Traditional Medicine, Phatsart Songkhro, Conservative Version.
3rd ed., Bangkok, Chulalongkorn University Publishing, 2015. (local language)
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 30
STRESS COPING OF ELDERLY IN COMMUNITY
Nitaya Sichamnong
College of Nursing and Health, Suan Sunandha Rajabhat University, Thailand
E-mail: [email protected]
INTRODUCTION
Stress is what happens to everyone. Especially in the fast changing circumstances. This affect the
mental health of a person.The elderly are easily exposed to stress. They are considered being a vulnerable
group. Their bodies gradually deteriorate and have both physical and mental changes such as having dry skin,
slower response to stimulus, degenerative eyesight, poor nervous system, fragile bones, poor muscle
strength, and having degenerating organs. ( 1) Elderly people are at high risk of stress, which may cause
physical and mental illness. When stress occurs, people will face stress or face problems in various
waysthrough thinking or behavior to maintain balance in the body. (Lazarus &Folkman,1984 said that when
persons have stress, they will adjust to face with stress in 2 styles; Problem-focused copingand Emotion-
focused coping. Each person uses both coping styles.Whichever style is used depends on the situation of
stress. The research of Nittaya SriChamnong. (2556) found The elderly are exposed to stress that may cause
health problems the coping behavior of the elderly. Understanding coping in elderlyis interesting to
study.Researcher has been interested in studying the coping behavior of the elderly to get information for
promote the elderly to have proper coping for better quality of life.
OBJECTIVES
To study stress coping of elderly people in community.
LITERATURE & THEORY
This research has reviewed the concept that relates to stress coping and will concisely present as
follows;
1. Situation of the elderly in Thailand
Nowadays, Thailand is an ageing society which its population has increased rapidly since 2000 when
the proportion of the elderly (60 years or older) reaches 10 percent of country population and the country will
become “completed ageing society” when percentage of the elderly population reaches 20 in 2021. Moreover,
the country is expected to be a super ageing society in less than 20 years when percentage of the elderly
population is 28 percent of all country population. ( 2) Now that the elderly have some changes in both
physiological and mental health resulting from degenerating systems in their bodies.
2. Stress Coping
Stress means the pressure of a person when something is threatening. It causes an imbalance in the
body, mind and emotions.Stress coping refers to the response used by individuals to reduce or cure stress
through thoughts or behaviors that people use. Lazarus &Folkman (3) said that when persons have stress,
they will adjust to face with stress in 2 styles; Problem-focused coping and emotion-focused coping. Each
person uses both coping styles.Whichever style is used depends on the situation of stress.
Jalowiec ( 4) developed the tools for measurement stress coping under the concept of Lazarus
&Folkman(3) . There are three types of coping styles; confrontive coping , emotive coping and Palliative
coping. People who have proper stress coping can successfully manage the cause of stress. People with
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 31
ineffective stress coping, the stress was reduced temporarily. ( 5) Person who use of coping styles s in a
manner that is not suitable for a long time. The body can not adapt, it may be harmful to health.
the measurement of coping that was developed by Jalowiec composed of 3 styles. The first one was
confrontive coping, it is a way to control the problem in a better way. The second one was emotive coping.,
it is a way of venturing emotions where the problem persists. The last one was palliative coping, it is the
method used to solve the problem indirectly , which The problem does not change.
METHODOLOGY
1. Research Method
This research is quantitative research. Sample was 148 elderly people of one community in
Bangkok.
2. Research Instrument
Instrument used in this research is a questionnaire about stress coping styles which was adapted form
Jalowiec (1993). The research instruments composed of 3 parts. Part 1: Confrontive coping, There are 10
items were 1) Try to find information to understand the problem , 2) Control the situation or the cause of
the problem, 3) Try to identify problems and solve them, 4) Understand the problem clearly in all aspect , 5)
Solve the cause problems to better handle problems, 6) Find out how to solve problems and choose the best
one, 7) Try to calm, and find a better way to face problems, 8) Do activities or exercises to reduce stress, 9)
Consult with a trusted or experienced person, 10) Ask for help from family or friends. Part 2: Emotive coping
, There are 10 items; 1) Anxious expression, 2) Angry expression 3) Prepare yourself for the worst situation
that you think will happen, 4) drink, eat, smoke more, 5) Dream up, 6). Throwing things, 7). Violent
behavior with another person , 8) give reason that your thinking are correct, 9) Think that another person
caused the problems an 10 Isolate alone. Part 2: Palliative coping, There are 10 items;1. Accept the situation
of problems. 2. Look for something better to compensate.3. stay still and think that the problem is solved by
itself.4 smile with the problem 5. Do not do anything because it is a matter of fate. 6. Let the problems go on,
it can not be changed. 7. Comfort yourself not to worry. 8. Sleep by thinking that problems will improve in
the morning. 9. Try to forget the problem and 10) depend on the sacred. It is rating scale questionnaire in 3
level; often practice, practice in sometimes and not often practice.
3. Data collection
The data was collected in June , 1960.
4. Sample Protocols
The researchers take into account the rights of the sample by explanation the purpose of the research,
research process , the duration of the research and clarify the right to accept or decline participation in this
research. The presentation of the information will be presented as a whole, no name and surname of sample
present in the research paper.
5. Data analysis
Data were analyzed using computerized data analysis program. Statistics used in data analysis
consisted of frequency, percentage, mean and standard deviation.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 32
RESULTS
1. General data of the respondents
The data shows that 61.49% of the elderly are female. 57.42 % aged between 60-70 years. 47.97% have a
marital status, 24.32% are single and .47.97%had secondary education, 26.35% had primary education, 41.89%
are employee. 38.51% have monthly income from 10,000 to 15,000 baht.35.81% have son or daughter as
caregivers and supporters.
2. Stress Coping
2.1 Confrontive coping
The result shows that the elderly used the most 3 types of confrontive coping as follow; item 1.
Try to find information to understand the problem (× = 2.63 SD = 0.48) , item 4. Understand the problem
clearly in all aspect (× = 2.62 SD = 0.51) and item 2. Control the situation or the cause of the problem.( × = 2.60
SD = 0.49). While the 3 least expressions confrontive coping were: item 8. Do activities or exercises to reduce
stress.( × = 2.25 SD = 0.71), item 10. Ask for help from family or friends. (× = 2.30 SD = 0 .6 6 ) and item 9.
Consult with a trusted or experienced person. (× = 2.32 SD = 0.64)
2.2 Emotive coping
The result shows that the elderly used the following top 3 of emotive coping were : item 10. Isolate
alone (× = 2.12 SD = 0.86), item 8. give reason that your thinking are correct (× = 2.11 SD = 0.69) , item 1.
Anxious expression (× = 1.89 SD = 0.62) . While the 3 least expressions of emotive coping were item 6
Throwing things (× = 1.38 SD = 0.57), item 2 Angry expression (× = 1.47 SD = 0.58) item 7. Violent behavior
with another person (× = 1.48 SD = 0.65)
2.3 Palliative coping
The results shows that the elderly used the following top 3 of Palliative coping were item 1 Accept
the situation of problems item (× = 2.74 SD = 0.44), item 10. chanting and depend on the sacred (× = 2.63 SD
= 0.62), item 2 Look for something better to compensate (× = 2.61 SD = 0.55) While the 3 least expressions
of Palliative coping were item 5 Do not do anything because it is a matter of fate . (× = 2.01 0.63 ) item 8. go
to Sleep by thinking that problems will improve in the morning. (× = 2.21 SD = 0.65) item6. Let the
problems go on, it can not be changed. (× = 2.22 SD = 0.68)
DISCUSSION AND FUTURE WORK
The result of this research found that the elderly used the 3 styles of coping together and used
confrontive coping more than emotion coping and palliative coping. effective adaptation requires proper
three styles of stress. People who adapt well will need to know the situation which consistence between
demand and resources. They know how to choose the right way to deal with stress and use proper coping
styles to confront problems. Person who manage stress with feelings, it is not good for themselves. (Lazarus
& Folkman, 1983). People who use palliative coping, it does not solve the causes of problem . People who
use confrontive coping , the problem will be solved appropriately.
ACKNOWLEDGEMENTS
I would like to express my sincere thanks to Suan Sunandha Rajabhat University for invaluable help
throughout this research.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 33
REFERENCES
[1] Department of Health (2014), “Exercise in the elderly”, URL: http://library.thaihealth.or.th/
[2] T he Foundation of Thai Gerontology Research and Development Institute (2014), “Situation of The
Thai Elderly”, URL: http://thaitgri.org.)
[3] Lazarus &Folkman (3)1984
[4] Jalowiec (1993)
[5] Ignatavicius& Bayne, 1991 : Beare & Myers
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 34
PERCEPTION OF SELF EFFICACY AND DELIVERY SKILLS
OF NURSING STUDENTS
Assist. Prof. Oranuch Chaopreecha
Faculty of Nursing and Health, SuanSunandhaRajabhat University, Bangkok, Thailand,
E-mail: [email protected]
ABSTRACT
The purpose of this study is to study the self-efficacy and delivery skills of nursing students after
delivery practice in Maternal and Newborn Nursing & Midwifery Practicum 1. The population and sample are
60 nursing students in year 3. The research Instruments are the questionnaires of self-competence in the practice
of the delivery and the questionnaires of opinions about the capability of the delivery skills. Data was collected
from nursing students who had practiced delivery procedures at hospitals and had truthfully answered the questions in the questionnaire; the investigation shows that:.
1. the highest mean score of self-efficacy in the practice of the delivery competence the score of
nursing students is the confidence of improving the delivery knowledge and skills increasing (�̅�
= 3.68 SD = .69) on the other hand the lowest mean score of self-efficacy in the practice of the
delivery is the confidence of being able to solve any problems during the delivery process (�̅� =
2.75 SD = .70)
2. the highest mean score of opinions about the capability of the delivery skills questionnaires is
getting ready for delivery procedure of nursing student (�̅� = 3.89 SD = .38) on the other hand the
lowest mean score is the delivery for the new born baby’s head (�̅� = 2.69 SD = .41) however the
part of cutting and stitching the perineum wound has no score.
Keywords: Self-efficacy, Delivery, skills
INTRODUCTION
Suan Sunandha Rajabhat University has provided a Bachelor of Nursing Science Program which
teaches both Theory and practice in order to produce nurses who understand the theory and have the neccessary
practical skills and confidence required to successfully undertake the maternity delivery procedure. The
practice that has been provided is very important for the nursing profession because the nursing students need
the theory and the skills for the reasonable use of the nursing practicum in the simulated situations,that means
that the practice in a simulated situation is crucial for a nursing science program.
According to the nursing students’ they found that practicing situations in the clinical practice
laboratory, led to the nursing students having more pressure and stress on practicing than on the theory. A study
by, Becker & Neuwirth,(2002); Shipton,(2002) said that when having to undertake practice sessions, especially
where someone has never had experience in such a session before it will cause more pressure and stress, so in
our practical nursing courses we train the students to be ready for real situations by providing the practice
before going to the clinical practicing laboratory.
the labour and delivery unit is one of the Bachelor of Nursing Science Programs which is planning
on giving the nursing students practical experience in the labour and delivery unit. The students have to practice
on taking care of pregnant women and the new born babies. The delivery is an especially high skill for nursing
students to master so training in that area is essential as it needs competence in nursing skills that are way
above basic nursing skills; the skills needed are the ability of analysise , the ability to make decisions on
methods needed to solve sudden problems that may occur during the labour process.
The Faculty of Nursing and Health, SuanSunandhaRajabhat University has provided a specific
delivery practice unit in the labour and delivery unit for Maternal and Newborn Nursing & Midwifery
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 35
Practicum 1. The Faculty of Nursing and Health has prepared the nursing students to be ready before delivery
practice and also to manage the practice timetable for 7-8 days continuously in order to giving the nursing
students experiences of taking care of mothers and new born babies. Continual practice will give the nursing
students more confidence on taking care of mothers and new born babies. It was this reason of increasing the
confidence and the efficacy in skills needed which inspired the researcher to investigate on self-efficacy in the
practice of the delivery of nursing students’ skills who have experiences of delivery skills in Maternal and
Newborn Nursing & Midwifery Practicum 1.
The purposes of the study
1. To investigate the self-efficacy and delivery skills of nursing students.
2. To investigate the opinions about the capability of the delivery skills
METHODOLOGY
This is survey research to study the knowledge and abilities of deliveries undertaken by the nursing
students themselves and the opinion of the nursing students regarding the practical delivery ability of nursing
students.
Population and sample: 60 students in the Bachelor of Nursing Science Program year 3 of students
who have been practicing in the labour and delivery unit in the 2nd semester of the academic year 2017. The
sample was chosen by Purposive sampling. The students who have enrolled in Maternal and Newborn
Nursing & Midwifery Practicum 1 and have been practicing in the labour and delivery unit for 7-8 days.
Research Instrument
1. The first unit is a questionnaires of comprising 10 questions relating to self-efficacy in the practice of
the delivery of nursing students. I, the researcher have created the questionnaires myself by studying
books and literature that relates to this study. These questionnaires are designed to use the Likert scale
for the measurement and Evaluation of the answers which is graded into a 5 numerical rating scale.
2. The second unit of questionnaires are used for asking for opinions about the capability of the delivery
skills of nursing students. I, the researcher have created the questionnaires myself by studying from
books and literature that relates to the delivery procedure. The questionnaires are concerned with 10
aspects and each aspect consists of 5 questionnaires. These questionnaires use the Likert scale for the
measurement and Evaluation which is graded in to a 5 numerical rating scale.
Quality check on research data collecting tools
1. Both units of the questionnaires have been checked for the content validity by 2 professionals who
have been teaching the Nursing Science Program and these questionnaires have been corrected
following the advice of the professionals.
2. The researcher has piloted these questionnaires with 30 year 4 nursing students in order to check
reliability, by using Cronbach’s alpha coefficient and has found that the reliability of self-competence
in the practice of the delivery questionnaires of nursing students is 0.74 and the reliability of opinions
about the capability of the delivery skills questionnaires of nursing students is 0.82
Data collection
Collecting the data by informing the students of the purpose of the study on the date that introduced
the course, also by asking for volunteers to give their opinions of self-competence in the practice of the delivery
and opinions about the capability of the delivery skills, also asking the students to sign an agreement form
giving their consent of joining in this research after the students have had experience of delivery practice from
where they will be trained, the students will answer the questionnaires honestly.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 36
RESULTS
Section 1 General Information 60 nursing students: divided into females 86.9 % and males 13.1% ,
Number of students and the place of delivery practice: 30 students at Queen Savang Vadhana Memorial
Hospital, 12 students at Rajavithi Hospital, 18 students at Kratum Baen Hospital. 45% of students had had 1
experience of practice in the labour and delivery unit, 55% of students had had 2 experiences of practicing in
the labour and delivery unit.
Section 2 the self-competence in the practice of the delivery score of nursing students. According to
the data analysis of self-competence in the practice of the delivery score of nursing students after the experience
of delivery practice as shown in Table 1.
Table 1
The mean and the standard deviation of self-competence in the practice of the delivery score of nursing
students after their experience of delivery practice
NUMBER
DETAIL
SCORE
�̅� SD
1 I am confident to say that I have the knowledge and understanding in
both the theory and the practice of delivery. 3.12 .72
2 I am confident to say that I have the ability to use the knowledge of
delivery correctly. 3.25 .67
3 I am confident to say that If I operate in delivery next time, I will have
better control of my excitement. 3.25 .73
4 I am confident to say that If I operate in delivery next time, I will be able
to follow every order of the delivery process step by step. 3.05 .83
5 I am confident to say that in future operation of delivery I will be able to
make decisions on the delivery procedure myself. 2.80 .84
6 I am confident to say that I will be able to evaluate and analyze the
mothers’ problems for future proceedures regarding delivery. 2.83 .77
7 I am confident to say that if there are any problems that happen during
the delivery, I will be able to solve them. 2.75 .70
8 I am confident to say that I have improved my delivery knowledge and
skills. 3.68 .69
9 I am confident to say that I can manage to complete the delivery process
even if I don’t like it. 3.25 .70
10 I am confident to say that I am able to summarize and present a case
study of the delivery to classmates and lecturers
2.97 .78
Table 1 shows that the highest mean score of self-competence in the practice of the delivery score of
nursing students is the confidence of improving the delivery knowledge and skills increasing (x = 3.68 SD = .69)
on the other hand the lowest mean score of self-competence in the practice of the delivery is the confidence of
being able to solve any problems during the delivery process (x = 2.75 SD = .70)
Section 3 the opinion on the nursing students’ ability of delivery practicing
After analyzing the collected data of the opinion of delivery practicing ability of nursing students after gaining
delivery experience as shown in table 2.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 37
Table 2
The highest mean score of opinions about the capability of the delivery skills
NUMBER
DETAIL
score
�̅� SD
1 Getting the pregnant mother ready for the delivery procedure 3.73 .40
2 Getting nursing student ready for the delivery procedure 3.89 .38
3 Preparing the mother’s birth area ready for the delivery procedure 3.73 .35
4 Preparing the maternity cover and maternity wear for the mother 3.80 .29
5 Cutting and stitching the perineum wound 0 0
6 Safe perineum 2.69 .41
7 Post-delivery assistance for the new born baby’s head 3.28 .41
8 Assistance with the new born shoulder and body delivery 3.22 .60
9 Care needed for cord cutting 3.70 .39
10 Instruction regarding placenta delivery 3.51 .38
Table 2 shows that the highest mean score of opinions about the capability of the delivery skills
questionnaires is getting ready for delivery procedure of nursing student (x = 3.89 SD = .38) on the other hand
the lowest mean score is the delivery for the new born baby’s head (x = 2.69 SD = .41) however the part of
cutting and stitching the perineum wound has no score.
CONCLUSION AND FUTURE WORK
According to the study of self-competence in the practice of the delivery after delivery practicing
found that the nursing students are quite confident on the knowledge and the ability of deliveries because most
of the students have been trained to be ready before practicing and trained at the nursing internship for 7-8
days. 45% of the nursing students have 1 delivery case experience and 55% have 2 delivery case experiences
which conforms to Bandura( 1977) idea about perceived self – efficacy, which said that anyone who has
performed anything that relates to their knowledge and ability. The knowledge and ability become part of the
thinking process which gives people self- confidence of doing things and they will perform and behave in order
to manage to reach their target. So knowledge and ability have an impact on performing. This study focuses on
studying self-knowledge and ability on delivery which shows the understanding of nursing students’ abilities
or self-confidence on delivery performance as expected and intention of being able to finish the delivery. Our
department has provided a practical section. This section trains the nursing students to be ready for delivery
by demonstrating the delivery process to them also it has been providing the delivery practice at hospitals
which gives the nursing students self- confidence to perform in the delivery procedure. The ability of solving
problems during the delivery procedure score is quite low but the nursing students have only had 1 or 2
experiences of delivery practice.
Moreover the study of the opinion about the ability on delivery practice of the nursing students after
having had delivery experiences, found that the score of getting the pregnant mother ready for the delivery
procedure has the highest mean score that means every student prepares and gets ready before performing in
delivery procedure. Most of students have been trained to be ready for dressing up, putting on gloves, cleaning
the pregnant mother and preparing the maternity cover and maternity wear by the instructor in the labour and
delivery unit, 56.40 percentage have practiced with friends, 13.34 percentage self- practicing, 32.45 have
practiced at the labour and delivery unit where they have been trained, which makes the opinion of getting the
pregnant mother ready for the delivery procedure to have the highest mean score by providing the simulated
situation of labour and delivery unit. This allows the nursing students to be able to practice as the study of
Supparat Jamjanget, which found that the preparation of getting ready for nursing performance in the simulated
situation helps students have a better understanding and have the ability for nursing performance. On the
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 38
contrary the delivery assistance for the new born baby’s head has the lowest mean score because few simulated
situations were provided and also because of the different conditions of pregnant mothers.
SUGGESTIONS
1. A study needs to be made of the comparison between self-competence in the practice of delivery
and the opinions about the capability of the delivery skills of nursing students that have different
delivery experiences.
2. A study is needed to provide the simulated situation of labour and delivery unit for nursing students’
delivery practice.
3. A study is needed to gain the opinion of delivery skills from the aspect of the instructors and the
advisors
ACKNOWLEDGEMENTS
I would like to express my sincere thanks to Suan Sunandha Rajabhat University for invaluable help
throughout this research.
REFERENCES
[1] Bandura, Aibert.(1977). Self-efficacy: Toward a unifying theory of behavior. Psychological
Review. 84(2): 191-215
[2] Becker, M.K., & Neuwirth, J.N. (2002). Teaching strategy to maximize clinical experience with
beginning nursing students. Journal of Nursing Education, 41(2), 89-91.
[3] Shipton, S.P. (2002). The process of seeking stress-care:coping as experienced by senior
baccalaureate nursing students in response to appraised clinical stress. Journal of Nursing
Education, 41(6), 243-56
[4] Supparat Jamjanget, et al. (2018). Effects of Using Simulation-Based Learning for Preparation of
Nursing Practicum on Perceptions of Self Efficacy in Performing Nursing Care in a Hospital.
Nursing Journal of The Ministry of Public Health. 27 (Special Issue December) 46-58
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 39
THE RESULTS OF USING MIXED LESSONS OF FOLK SONGS FOR
NURSE STUDENTS IN NURSING CARE OF WOMEN
DURING CHILDBIRTH
Boonsri Kittichottipanich* & Sumitta Swangtook**
* Instructor of Nursing and Health College, Suan Sunandha Rajabhat University, Thailand
**Instructor of Kuakaroon Nursing Faculty, Nawamintrathiraj University, Thailand
E-mail: *[email protected], **[email protected]
ABSTRACT
This research is a quasi- experimental research to study the results of knowledge enhancement and
understanding of nurse students for women during labor and childbirth nursing by using traditional music
lessons. The knowledge and emotions and feelings of students after listening to the lessons of folk songs were
measured. The sample consisted of the third year of nursing students, academic year 2560, Nursing and Health
college, Suan Sunandha Rajabhat University. A total of 49 purposive sampling from volunteer nurse students.
Data collected from 1 February 2016 to 31 March 2560 for two months. The instruments used in this research
were 1) mixed lessons with folk songs. 2) Knowledge of pre- listening and post- listening test. 3) Emotional
and feeling recording after listening to the lesson. There are two parts to analyzing the data: Part 1: comparing
knowledge before and after listening by using pair t-test as statistical tests. Part 2 for qualitative data analysis
by using content analysis, which focuses on interpretation, generates conclusions from the record, reflecting
the emotions of students after listening to folk song lessons. The results of the study revealed that the
knowledge after listening to the folk songs was significantly higher than the pre-listening level at P <0.01. By
qualitative data analysis from the student's emotional and feeling notes, after listening to the folk song lessons
showed that students' knowledge gained of the content of delivery nursing in each stage of labor: stage 1, stage
2, stage 3 and stage 4 of childbirth. Consideration the ordering of priority by the benefits and content of the
student that gained up, the first step was to gain knowledge and understanding of the content and the melody
of the song and followed by number 2. Have fun in learning and relax. 3. Know that the folk music is
melodious. 4. The introduction to the lesson is interesting in the first song, starting with the basic knowledge
in the delivery. 5. Lessons are sorted, sorted, easy to understand. 6. Lessons for music it is easy to listen, easy
to carry, easy to listen to. 7. Lessons are summarized in each section appropriately. 8. The use of language can
be meaningful.
The results of this study, in addition to showed according to the objectives of this study. It was
important that the student was impressed with the poem in lesson. It is suitable for education in the era of
Thailand 4. 0 and Z generation because it is ready to use media. In addition to academic knowledge, it has
instilled students into the people who love to learn virtue and love values in Thai culture along together. The
advantage of this study is that the folk music lessons are academic and entertaining and cultural, can be used
as a guide to the application of multimedia to use in teaching other topics suitable for the next generation Z.
Keywords: childbirth nursing care, Nursing during Delivery, Nursing lessons with Folk music,
Nursing students
INTRODUCTION
Learning and teaching problems in obstetrics nursing revealed that teaching methods are very
important to design teaching to suit students. Although teachers have a good knowledge of the content and try
to choose the teaching method in accordance with the content and ability of students. Teacher try to choose
the easy way to get the students to the idea quickly and remember to use.
At present, obstetrics is one of the problems with teaching. Students have difficulty understanding
due to the nature of obstetric nursing, especially in labor, the content is rather difficult and abstract, so that
student must be creating an imaginary. The ordinary Obstetrics consisted of the vocabulary that students were
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 40
not familiar before. The students will have stress from being misunderstood there for the teaching of obstetrics
must change from abstract to tangible and seeking the method that increase understanding and must be tailored
for generation Z nursing students. The unique perspectives of generation Z student which based on life
experiences that influence career decision making. (Smith-Trudeau P., 2016) [1] Generation Z characterized
by loyalty, want to find a solution, and know what goals to look for, have a short attention, be impatient, learn
with a mobile phone or other tablet device that provides connectivity to the Internet and information for
accessing online content. They need to learn independently, initiative and in accordance with their own pace,
do not like teaching as a lecture. (Hampton, D, and Keys, Y., 2017)[2].
Barley S. ( 2016) [ 3 suggests that hybrid models are associated with the integration of classroom
learning experiences across the Internet and the traditional mix to enhance the benefits of technology and the
Internet to generation Z students. They learned by using concrete which can be seen and seen with the eyes
and then leads to the conclusion. Teaching methods should be based on new ideas. (Barley S., 2016) [3].
In 21st Century, Thai students must maintain a good culture of Thailand with the skill by focusing
on critical thinking skills so that teaching needs to be substantial in many ways. It is also equipped with modern
learning tools and the course contents will change according to the knowledge in the modern world with the
important learning and deep learning that will lead to innovation in the end. [4] (Chandra Thepcharoen, 2560)
This research aims to use the lessons mixed of Thai folk song with content of delivery nursing
composition of the subject for reviewing nursing knowledge in childbirth and reduce stress with music. In
order to improve the learning by listening lesion with music, promoting good mood, happiness with the subject
to meet the university goal of well- being increase of using computer technology promoting learning which
support to achieve learning objectives. That is the main of goal that learn happily and maintain Thai culture.
OBJECTIVES
1. To study nursing knowledge in childbirth after listening to traditional music lessons .
2. To study the emotions of students after listening to traditional music lessons .
METHODOLOGY
This research was Quasi-Experimental Research
Population consisted of 119 students in the third year of nursing student. Of 49 volunteers of the third years
nursing students were the sample in this study. They enrolled in this study during 1 February, 2 0 1 6 to 31
March, 2016 for 2 months to study the lessons with a mix of folk music.
Research instruments
The instruments used in this study were:
1. Lessons with a mix of folk music nursing care consisted of 5 folk song lessons.
2. Reflection recorded the feeling of the students before and after listening to the folk song lesson.
The researcher collected data in two parts.
Part 1: Childbirth nursing knowing before and after listening to the folk song lesson.
Part 2: Study of emotion and feeling of students before and after listening to the folk song lesson.
Data Analysis
Data analysis had the following steps.
1. Comparative knowledge score before and after listening to folk song lessons by using Pair t-test.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 41
2. Qualitative data from the students' emotion and feeling recording before and after listening to folk
song lessons by using content analysis.
RESULTS
This research Quasi- Experimental Research " Knowledge enhancement. Understanding the
nursing process in nursing students using the folk music lesson in teaching nursing students " in data
analysis. Researchers have the following steps.
Part 1: Comparative knowledge score before and after listening to folk song lessons. Of 49 nursing
students as a sample. The results showed that the mean knowledge scores of postest evaluation were
significantly higher than pretest and it was significantly different at P <0.01 as shown in Table 1ธ.
Table 1
Shows the results of the pre-test and post-listening test
Test N mean SD t df Sig(2-tailed)
pre-listening test
post-listening test
49
49
38.1
45.1
14.7
16.6
-5.22 48 .0001*
** Difference is significant at the 0.01 level (p < 0.01)
Part 2. Analysis of emotional and feeling reflection of students after listening to folk music lessons
using qualitative data from the reflection recording before and after listening the 5 songs of the lesson.
Reflection of feeling before listening
Nursing students reflect on their feelings. “ Will I listen? I'm excited that the basic knowledge of
maternity music will be released in the form. Feel that listening to music just a few minutes, then do the
knowledge increase or real. It will attract us as well. The content may be difficulty understanding and content
may be inconsistent, intend to listen to music. The original knowledge is confused because of the strict
memorization, unlikely to understand the content but music listening, may be help me to remember the steps
better. I wonder what the content will be, feel like listening that I have not heard the excitement to hear it. I
want to learn more, make it easier to remember. There is something to be heard. Interested in the novelty of
being a music composer. Expect to listen to music. Feel that I understand the song or think of the song. And
what is the birth of the baby?”
Reflection of feeling after listening
Nursing students reflect on the following feelings: " Easy to understand, although did not read the
textbook before. The article on Normal Labor and the mechanism of childbirth in 8 steps to make it easier to
remember. Get knowledge along with enjoyment, I have to listen to every day. Lyrics are more fun than
reading only, arrange the correct mechanism that the mechanism before or after, can get the basic knowledge.
Comprehensive review of the impressive mechanism of content compaction, listen and feel that it helps to
remember easily, feeling interested in listening. I understand more and more comfortable listening. Listen and
understand the memory of the textbook, if you listen more often, it will make more sense. If I listen often, it
may help me to have a good exam. More knowledge with fun with interesting music, use it to memorize, can
be stimulated to remember and can be used to sort the process well, birth of a baby from a baby's head, give
birth to the baby. The music is interesting to think of, the mechanism of the birth of the child in order to hear
more, get knowledge from listening without memorizing. The lyrics are after the listener, while thinking of
the lyrics feel free to indulge in music and feel relaxed over reading. I feel easy to think according to the
content each mechanism is described clearly concise content listen to easy to understand each word and get
complete knowledge of the steps."
By ranking numbers of impression toward the folk song lesson of reflection, shown in Table 2: The
first numbers of impression are benefit from lesson. The over all of reflection from record by nurse students.
The results show that nurse students had gain knowledge and understanding of the academic content and the
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 42
melody of the song. The lessons are sorted, sorted, easy to understand, lessons are appropriate content in each
episode and meaningful of language.
Table 2
The view of overall by ranking numbers of impression toward the folk song lessons of nursing students
The View of Overall Ordinal Numbers
- Benefits from lesson that to get more knowledge and understanding of the
academic content and the melody along together
1
-Have fun in learning and relax 2
- When listening, let's know that this folk lesson is melodious, not boring, easy
to remember Have known that the folk lesson is melodious and, the academic
content as a poem that is rhyming, not boring to use and easy to remember
3
- The introduction to the lesson is interesting in the first song, starting with the
basic knowledge in the childbirth
4
- Contents were sorted, easy to difficult, easy to understood 5
- Content is consistent with learning goals 6
-Easy to listen, can be recorded in the mobile phone is ready to listen easily 7
- Lessons are finalized in each episode 8
-The use of language can be meaningful. 9
The results of the reflection on the music lessons in the delivery. Satisfied feel free to self-learning and joy of
learning with in tone of music.
Suggestion from Nurse Students Reflection
Nursing students reflect the following suggestions. "The English pronunciation is clear, should have
a picture and video with accompanying text. It should be easy to understand and easy to use modern music,
changing to the current genre, easy to sing and easy to remember, want to have more songs, it should be a
simple listening song or a poem, let us sing every day, and ought to make more tone of sound. "
DISCUSSION AND CONCLUSION
The results of the two main issues discussed in the discussion were as follows.
The first was that nursing students had more knowledge about nursing in the postpartum period after
listening to the folk songs. The score from the test was higher than the pre- listening score, the composite
lesson, the folk song and the difference at the significant level ( P <0. 01) . Music and music are useful for
promoting learning. Helps make difficult lessons easier. Memorize the content easily. [5],[6] (Siripat Jetsada
Viroj 2007, Narong Kanjana 2009).
"I like the song, and the chorus is easy. It makes the content that is difficult to find it easy to learn. "
"It's a good lesson with folk music."
"Before I thought that would be possible. The difficult lessons become to be a soft song and
described of women during child birth."
"When I remember the lyrics that will increase understanding."
From Adolphs and Schmitt ( 2003) [ 7] found that the use of rhyming words helped to improve
memory. It concludes that the teaching of mixed music, low frequency increased recognition and
understanding of academic vocabulary. As the results of the study of Arleo ( 2000) [ 8] and Kao & Oxford
(2014) [9] shown that songs and poems are useful for verbal learning and summarize the relevant patterns of
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 43
human memory associated with thinking, music and poetry related to the memory and conclude as a musical
memory.
From the results of students have increased knowledge after listening to music lessons ended, and
feel comfortable to music lessons, relaxing and knowledge gaining when repeated listening, resulting in
learning together with the good mood because the rhythm of the music is slow tempo. The emphasizing the
words in the song will help students to be able to remember the song and poetry has increased, according to
Purnell-Webb and Speelman (2008) [10] and the study of Baddeley (2000) [11] described the processing of
sentences that occur when more information about the structure. Ludke ( 2010) [ 12] conducted a quasi-
experimental study with two classrooms. The learners started learning French in early Scottish, over four
weeks each class receives sixty- five lessons from the lessons that are inserted into music related to the song.
Music lessons that results in recognition and understanding with "learning to listen and repeat". (Anton, 1990)
[ 13] . The feeling was repeated by the songs which combined in this lesson that will result in enthusiastic
learners. The study of Arleo (2000) [8] and Kao & Oxford (2014) [9] found that the pop music can promoted
language learning and vocabulary were better after using music in the classroom. From the result of this study
found that what actually happened to the students were "Repeat the request. I like the song better and better.
Make sure to remember the content that is difficult to feel that easy to learn. There are lessons that are different
from other songs. It is a song that should be preserved and valued. A lesson in music to encourage more
learning. " " Get knowledge along with enjoyment " represents the song helps to remember the key words in
the lesson. The results of this study are in line with the study of Aquil, 2012[14]; Kerekes, 2015[15] Abbott,
2002[ 16] by learning vocabulary refers to acquiring, combining and enhancing vocabulary, including the
knowledge of multiple word units. While teachers use music for a variety of teaching purposes, repeated
requests are useful for teaching and learning vocabulary, include phrases and expressions that are longer so
that the song is a memorable resulted. It is well understood that it is useful for memorizing words, due to
conclude. Pronunciation song high and low frequency vocabulary in the song and by the frequency of this
word makes a memory. According to a study by Adolphs and Schmitt (2003) [7] and Baddeley's study, Alan
D. (2000) [11] emphasized that typing and word processing can be linked and help in remembering well from
the rhythm and also the rate of speech. Kilgour, Jakobson and Cuddy ( 2000) [ 17] found that this was an
important variable, resulting in easier vocabulary recognition. In addition, Kilgour and colleagues [ 17] the
memory effect was higher, especially only when the lyrics are presented at a slower pace than speech and the
participants in the singing also get higher results. Rhythm of music affects memory, easy to remember. The
results of this study suggest that the perception of the students' feeling towards the music of this song is
significant. The first benefit is to gain knowledge and understanding of the content and the melody of the song.
According to what the students reflect on the content and the benefits, relax from music lessons.
CONCLUSION
The study reflected the importance of this folk song lession makes it easy for students to leaen the
difficulty content that exceeds expectations. Students get impressed with poetry. It is suitable for promoting
education in Thailand that emphasizes on providing academic knowledge together to create students who love
learning, morality and love in Thai culture, coupled with getting knowledge.
ACKNOWLEDGEMENTS
The Author would like to thank the Research and Development Institute, Suan Sunandha Rajabhat
University, Bangkok, Thailand for financial support.
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© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 44
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[16] Abbott, M. 2002. Using music to promote L2 learning among adult learners. TESOL Journal,
11(1), 10-17.
[17] Kilgour, A. R., Jakobson, L. S., & Cuddy, L. L. (2000). Music training and rate of presentation
as mediators of text and song recall. Memory & Cognition, 28(5), 700-710.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 45
THE DEVELOPMENT OF DELIVERY PRACTICE INSTRUMENT
AND ACTUALLY DELIVERY LEARNING OUTCOMES IN THE
NURSING STUDENTS
Asst. Prof. Dr. Sudpranorm Smuntavekin
Faculty of Nursing and Health, Suan Sunandha Rajabhat University, Bangkok, Thailand,
E-Mail: [email protected]
ABSTRACT
This research aimed to develop the delivery practice instrument and actually delivery practice
learning outcomes in the nursing students. A mixed methods design was employed and devided into 2 phases.
In phase 1: To develop delivery practice instrument by using both literature reviews and expert observed. Then
the delivery practice instrument was developed to questionnaire and investigated by the content validity with
IOC .840, internal consistency reliability coefficients .849. For phase II: Using the questionaire to survey the
actually delivery practice learning outcomes of 120 nursing students from public university and college of
Thai nursing institutes. The major findings could be concluded as follows: 1) The delivery practice instrument
consisted of 10 factors 50 items that guild the nursing students to practice step by step. 2) The actually nursing
students’ delivery practice learning outcomes had only 8 factors with high score and 2 factors with low score.
Suggestion that the delivery practicum training should provide available times to more practice and determine
more experience. Keywords: delivery practice instrument, student nurses
I NTRODUCTION
In nursing and midwifery education, the nursing student perceived that the delivery practice has become
challenged to learn. ( Burn & Peterson,2005) . But they had to be stressful, scary and exiting with the urgent
situations and complex skills that risk to pregnant mother health and child' life. They might forgot the delivery
skills and couldn’ t perform correctly steps ( Suwannobol & Suwachan, 2012) . that affected their learning
ability. Although literature found that students who take part in a clinical simulation developing their self-
efficacy ( Jeffries & Rizzolo ,2006) , Suggestion that the good performance testing should be demonstrat the
student' skill or psychomotor learning behavior (Wongvanich 2007). But the evaluation instrument for delivery
practice effective delivery tool has still not enough Researcher believed that the delivery psychomotor testing
possibility to improve the nursing student delivery practice skills. But limitted of studied showed how the
student' nurse improving their learning skill process and outcomes. If there is an effective delivery tool for the
nursing students to review and check theirself , propable improve their performance and learning outcome.
Researcher expect to develop an delivery practice instrument as a chectlist providing more learning behavior'
information as a mirror reflexion and use to measure their actually delivery learnin outcomes.
OBJECTIVE
1. To develop the delivery practice instrument for nursing student.
2. To study the actually delivery outcomes by using delivery practice instrument.
METHODOLOGY
Study design, Data collection and Analysis.
This study was mixed methods design which combines qualitative and quantitative research
techniques that can be devided into 2 phase as follow:
Phase I: To develop the indicators of delivery practice instrument.
1) Literature reviews with delivery concepts and procedures which were safe for the mother with
child bearing. The researcher extracted to delivery items lists and recheck by 3 midwifery experts.
2) Develop the questionaires with 10 indicators, each indicator consisted of 5 delivery steps/
Items which 4 Likert’s scale.
3) To investigate the quality of questionaires in relevance content and context approximately by 3
expert panel midwifery instructors at 3 nursing institutes that was .840. Then internal consistency examine by
25 nursing students that was 0.849
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 46
Table 1
Example blueprint of 1 the delivery practice’ indicator.
Indicators Items Item’ lists
6. . Neonatal head’
deliver.
5 1. Coaching and encourage to pushing while uterine
contraction
and pushing again for descend with head seen about 5 cm.
2. Control of Fetal head with slowly extend by gentle touch
at occiput for preventing of anterior vaginal canal
3. The other hand control and save of perineal tear
4. Support perineum and extending fetal head with slow an
gentle
5.Support the fetal head and chin with complete delivery
Phase II: To survey study the actually delivery learning outcomes by using the delivery practice
instrument
Study design: Descripive survey research.
Samples
The sample were 120 nursing student from private university and college of nursing.who enroll in
Maternal – child and Midwifery II and complete the delivery practice skills.
Data collection: After finishing the course, questionaires survey for learning ability/outcomes of
120 nursing students.
Statistical Analysis:for statistical analyzed by SPSS version 22.
RESULTS
Descriptive statistics
Of the total 120 nursing students who contributed in this study showed the ability’ background (table
1). The average theory grade was 2.79 ± .801, the average practical grade was 2.65 ± .840 and the number of
case was 2.12 ± .332.
Table 1
Backgroud of respondents. (N= 120)
Variables Mean SD Max Min Skewness Kurtosis
Theory grade 2.79 .801 4 2 .198 .528
Practical grade 2.65 .840 4 2 .048 .200
Number of delivery cases 2.12 .332 3 2 2.297 3.330
The delivery practice instrument consist of 10 steps and each step with 5 items. The nursing student
learning ability of delivery outcomes were 8 factors with high score as follow: 1) External genitalia cleaning
2) Cord cutting & care 3) Nurse preparation 4) Delivery sheaths daving 5) Placenta delivery 6) Postdelivery
neonatal assisting 7) Maternal preparation 8) Delivery of Neonatal shoulder & body. They can do 8 steps
undersupervised with their instructors or preceptors. Only 2 factors with low score 1) Neonatal head’ deliver
and 2) Perineum cutting & repaird that due to difficult to do and risk to the mother and child which need to
more training.(table 2)
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 47
Table 2
Delivery skill indicators/ factors
Variables Mean SD Min Max Sk Ku
1. Delivery Skills 32.170 1.06 29.20 34.00 -.390 -.577
1.1 Maternal preparation 3.447 .27 2.60 4.00 -.10 -.12
1.2 Nurse preparation 3.868 .19 3.00 4.00 -1.81 7.08
1.3 External genitalia cleaning 3.933 .15 3.20 4.00 -2.63 -.987
1.4 Delivery sheaths daving 3.853 .24 3.00 4.00 -1.75 2.20
1.5 Perineum cutting & repaird 1.008 .04 1.00 1.20 4.64 19.91
1.6 Neonatal head’ deliver. 1.247 .49 1.00 3.80 4.04 21.98
1.7 Postdelivery neonatal assisting 3.675 .32 3.00 4.00 -.379 -1.27
1.8 Delivery of Neonatal shoulder & body 3.445 .33 2.60 4.00 -.878 .154
1.9 Cord cutting & care 3.923 .09 3.80 4.00 -.598 -1.67
1.10 Placenta delivery 3.798 .21 3.20 4.80 -.980 -.52
CONCLUSION AND FUTURE WORK
According to this finding, The Delivery practice instrument for student’ nurses consist of 10 factors and
50 items. The using delivery practice instrument showed the nursing students’ delivery practice outcomes.
There were 8 factors with high score. All 8 factors were basic steps that not threathened to mother and child
and slowly to do. But only 2 factors they had the low score due to difficult and unsafe for the mother and
child. This 2 factors were advanced for midwifery and need to training further andgetting more experience.
A limitation of this study were 1) The developing delivery practice instrument need to study in various
contexts which consisted of difference delivery skills and need more samples to statistical analyzed by
constructed validity (factor anal confirmatory factor analysis) for the instrument quality. 2) The nursing student
delivery practice learning outcomes need to continuous training and get more learning exoerience.
REFERENCES
[1] Blaaka, G. (2006). Newcomers learning of midwifery practice in labour ward: A sociocultural
perspective. Learning in Healthand Social Care. 5(1), 35-44.
[2] Bluff, R,& Holloway, I. (2008).The efficacy of midwifery role models.Midwifery,24(3), 301-
309. Epub 2007 Feb 2.
[3] Brunstad,A,&HjalmhultE. (2014). Midwifery students learning experiences in labor wards: a
groundedtheory.Nurse Education Today, 34(12), 1474-1479. doi: 10.1016/j.nedt.2014.04.017. Epub
2014 Apr 29.
[4] Guimond, M.E.,&SimonelliM, C. (2012). Development of Obstetric Nursing Self-Efficacy Scale
Instrument.Journal of Obstetric and Gynecologic and Neonatal Nursing,41(1), S160- S161.
[5] Hughes, A.J.,& Fraser, D.M. (2011). There are guiding hands and there are controlling hands:
Student midwives experience of mentorship in the UK. Midwifery, 27(4), 477-483. doi:
10.1016/j.midw.2010.03.006. Epub 2010 May11.
[6] Jordan, R.,& Farley, C.L. (2008).The confidence to practice midwifery:preceptor influence on
student self-efficacy. Journal of Midwifery and Women's Health, 53(5), 413-420.
[7] Lange, G.,& Kennedy, H.P. (2006). Student perceptions of ideal and actual midwifery practice.
Journal of Midwifery&Women' s Health,53(5), 71-77.
[8] Muleya, C.M., Marshall, J.,&Ashwin C. (2015) Nursing and Midwifery Students’ Perception and
Experiences of Mentorship: A systematic Review. Open Journal of Nursing, 571-586.
[9] Maleewan Lertsakornsiri. (2014). The relationships between Personal factors and Stress, Stress
Management during practice in Labor Room of Nursing Students at Saint Louis College.
Journal of The Royal Thai Army Nurses, 15(2) May - August: 270-279
[10] Suwannobol, N.,&Suwachan, L. (2012). The practical delivery room experience of nursing students
at Suranaree university of technology. World Academy of science, Engineering and Technology,
71,405-408.
[11] Thunes, S.,& Sekse, R.J. (2015).Midwifery students first encounter with the maternity ward. Nurse
Education in Practice, 15(3), 243-248. doi: 10.1016/j.nepr.2015.01.012. Epub2015 Feb 7.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 48
ELDERLY HEALTH BEHAVIOR IN THE COMMUNITY,
BANGKOK, THAILAND
Anchalee Jantapo
College of Nursing and Health, Suan Sunandha Rajabhat University, Bangkok, Thailand
E-mail: [email protected]
ABSTRACT
This research aims to study the health behavior of the elderly in food consumption, exercise and
emotional management. The sample was 50 elderly people of one Elderly Club in Bangkok, Thailand. The
research instrument was a set of questionaire developing by the researcher on the concept of health
promotion in the aspect of food, exercise and emotion. The questionnaire is a 5-level valuation scale.
Analyze data using computer program., with a percentage. average score and standard deviation. The result
found that most of the samples were female between 60 and 70 years of age. BMI between 25.0 - 29.9. Most
of them use gold cards for medical treatment. Most had high blood pressure and hyperlipidemia, followed by
high blood pressure and diabetes. Dietary habits found that most of them always have the 5 food groups,
cooked food and 3 meals with fruits and vegetable, seldom drink alcohol and smoke Most do exercise
regularly, have a warm body before exercise, exercise at least 30 minutes 3 days a week. For the emotional
management, most had less stress, stress relief by prayer, friends and family activities. Most of them can
control emotions when angry.
Keywords - elderly, health behavior, elderly health behavior
INTRODUCTION
Thailand’s population structure has changed rapidly in the last 3-4 decades. The number of elderly
people has increased which leads the country to ageing society. In 2000-2001, more than 10 percent of Thai
population is 60 years old. From the Thai population projection, 2015 to 2030, Thailand will be in “ageing
society” condition which is the situation that the country has elderly people who are 60 years old or older
more than 10 percent compared to population in other age ranges in the same area. In the next 10 years, the
country will become completed ageing society which more than 20 percent of population is elderly people
who are 60 years old or older. The country is expected to be super ageing society in less than 20 years when
elderly people are more than 28 percent. (1)
The elderly are considered being a vulnerable group. Their bodies gradually deteriorate and have both
physical and mental changes such as having dry skin, slower response to stimulus, degenerative eyesight,
poor nervous system, fragile bones, poor muscle strength, and having degenerating organs. (2) From the
nationwide elderly health survey ( 3) , the result showed that many of the elderly have suffered from high
blood pressure, insomnia, muscle and joint pain, frozen shoulder, dizziness, limb muscle weakness, and
other diseases. The illness of the elderly is related to behavior. Therefore, the study of elderly health
behavior is necessary for getting data as a guideline to promote good health in the elderly.
OBJECTIVES
To study health behavior of the elderly in food habits, exercise behavior, stress and stress
management.
LITERATURE & THEORY
This research has reviewed the concept that relates to health behavior of the elderly in food
consumption, exercise, stress and stress management of the older people and present concisely as follows;
1. Situation of the elderly in Thailand
Nowadays, Thailand is an ageing society with its population that has increased rapidly since 2000
when the proportion of the elderly (60 years or older) reaches 10 percent of the country’s population and the
country will become “ completed ageing society” when percentage of the elderly population reaches 20 in
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 49
2021. Moreover, the country is expected to be a super ageing society in less than 20 years when percentage
of the elderly population is 28 percent of the country’ s population. ( 4) Now that the elderly have some
changes in both physiological and mental health resulting from degenerating systems in their bodies,
promotion of exercise is necessary. One of the proper activities is exercise promotion for good health in the
elderly.
2. Health behavior of the elderly
The Government’s policy is to focus on taking care of the elderly’s health by imposing strategy about
building strength and emphasizing participation of local, community, and related sectors. One of the
important things is to encourage the elderly to have a good health, to slow down ageing, and to live their
routine lives on their own. (5). World Health Organization (6) has mentioned three elements to improve an
active ageing in the elderly which are 1) being healthy ageing. 2) having security in life. 3) having
participation. Healthy ageing means having good physical and mental health in these following aspects;
eating clean and proper 5 food groups, drinking pure water, avoiding strong-flavoured food, smoking, and
alcohol, having regular exercise, having adequate sleep which is 7-8 hours a night, and practicing mind to
embrace reality in life (3). Moreover, healthy ageing includes being responsible for one’s health and having
health checked regularly. Another element is having security in life which covers economic security, saving
for living, accommodation, and health insurance. The third element is having participation which means
taking part in social activities, having relationship with family or community, and being a member of
favorite organization. This research is the study of related research about health behavior in the elderly.
This study investigated the elderly health behavior in the elderly club in Bangkok, study health
behavior in three aspects: food, exercise,and stress management.
METHODOLOGY
1. Research Method
This research is quantitative research. Sample was 50 elderly people in the elderly club in Bangkok.
2. Research Instrument
The instrument used in this research is a set of questionnaire which was created in accordance with
research purposes. The research instruments are composed of 2 Parts ; Part 1: the general information of the
respondents, Part 2: health behaviors in the aspect of food, exercise and stress management. It is a rating
scale questionnaire with In 3 levels; often practice, practice in sometimes and not often practice.
3. Data collection
The researchers collected data by themselves in April- July, 2017.
4. Sample Protocols
The researchers take into account the rights of the sample by explaining the purpose of the research,
research process , the duration of the research and clarify the right to accept or decline participation in this
research. The presentation of the information will be presented as a whole, no name and surname of sample
present in the research paper.
5. Data analysis
Data were analyzed using computerized data analysis program. Statistics used in data analysis
consisted of frequency and percentage statistics.
RESULTS
1. General data of the respondents
The data show that 74.00% of the elderly are female, 56.00 % aged between 60-70 years, 22.00 %
aged between 71 and 80 years and 8.00% over 80 years old. 38.00 % had a BMI between 25-29.9, which
was over nutrition. 18.00 % ,the BMI is between 18.5 and 22.9, which had an appropriate body. 46.00 %
has a marital status, 22.00 % are single and 20.00 % are married. 48.00% had primary education, 48% had
secondary education. 44.00% have monthly income from 1,000 to 5,000 baht, 28.00 % have monthly
income between 5,001 to 10,000 baht. 54.00 % t have the right to treatment from the gold card. 32.00 %
have the right to treatment from government. 20.00 % of respondents has high blood pressure and high
blood lipids and 14.00% is diabetic.
2. Food habits of the elderly.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 50
It was found that 76.00% of elderly had 3 meals a day. 68.00 % have the 5 food groups. 76.00 % eat
fruits and vegetables regularly. 80.00% eat cooked food on a regular basis. Only 4.00% eat sweet food,
6% eat high fat food and 6 % eat salty food . 96.00 % drink alcoholic beverages and smoke rarely. The
data were shown in Table 1
Table 1
Number and percentage general information of the respondents.
Dietary habits of the elderly Often Practice Practice in sometimes Not often Practice
frequency percent frequency percent frequency percent
1. have 3 meals a day 38 76.00 10 20.00 2 4.00
2. have the 5 food groups 34 68.00 13 26.00 3 6.00
3. eat fruits and vegetables
regularly
38 76.00
10 26.00
2 4.00
4. eat cooked food 40 80.00 7 14.00 3 6.00
5. eat a sweet food regularly 2 4.00 12 24.00 36 72.00
6. eat high fat food 3 6.00 10 20.00 37 74.00
7. eat salty food 3 6.00 10 20.00 37 74.00
8. Drink alcohol 1 2.00 - - 49 96.00
9. Smoking - - 2 4.00 48 96.00
3. Exercise behavior of the elderly.
Analysis of exercise behavior of the elderly found that 50.00 % of the respondents do exercise
regularly. 42 % allocated time for exercise. 42.00 % warmed body before exercise. 64.00 % likes to
exercise for health promotion. 52.00% do exercise at least 30 minutes in a day and 3 days a week. The data
were shown in table 2
Table 2
number and percentage of older people classify by practice in exercise
Practice in Exercise Often Practice Practice in sometimes Not often Practice
frequency percent frequency frequency percent frequency
1. do exercise regularly 25 50.00 10 20.00 15 30.00
2. Exercise time is allocated. 21 42.00 10 20.00 19 38.00
3. warm body before exercise. 24 48.00 11 22.00 5 10.00
4. like to exercise for health. 32 64.00 13 26.00 5 10.00
5. Exercise at least 30 minutes a day, 3
days a week.
26 52.00 11 22.00 13 26.00
4. Stress and stress management of the elderly.
From the assessment of the perception of the elderly. It was found that 50.00% of the elderly had less
stress, followed by 14% with moderate stress. In the relaxation of the stress of the elderly, 60.00% relaxed
by the way of praying. 64.00% by talking to friends. And 70.00% by sharing family activities.
CONCLUSION AND FUTURE WORK
1. Based on general data of the elderly, 38% of the elderly had BMI between 25 and 29.9, which is
overweight. This research is consistent with the research conducted by Soraya Kaewpitul and Nuttawut
Kaewpitul (7), which found that 15.37%. of the 400 elderly have a nutritional status exceeding. This finding
reflects that it is necessary to provide health promotion in food and exercise that is appropriate for the
elderly. Therefore, next research should focus more on motivation of exercise in the elderly since it is
important and necessary and can help improve the elderly’s health.
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 51
2. For the chronic disease was found in older people. They have diseases such as high blood
pressure, diabetes and high blood lipids. The same as Wajpolprasit Konkaew’s study (8), which found that
most of the elderly had moderate health status. The proportion of elderly with chronic diseases is similar to
those with no chronic diseases. Therefore, it should encourage the elderly to have good health by eating the
right food, do right exercise.
3. The results showed that most of the elderly eat three meals a day , the 5 groups of food ,cooked
well food, eat fruits and vegetables regularly. The respondents rarely eat sweet food, salty food and high fat
food. They also drank alcohol and smoked less. This is a healthy behavior. Unlike the study of Wipaporn
Sithisart, Suchada Suannum (9) found that the elderly in the other community always eat salty food.
4. In the Exercise Behavior aspect, from the analysis of exercise behavior of the elderly. It was
found that more than half of the elderly had regular exercise, at least 30 minutes a day and 3 days a week.
The results of this study showed that more than half of the elderly had appropriate exercise habits. As with
the research results of Sriprai Phorsingh and Anong Harnsakul (10) , which found that the elderly had the
knowledge to participate in health promotion in high level. Therefore, next research should continue to
focus on motivation of exercise in the elderly since it is important and necessary and can help improve the
elderly’s health. According to Anchalee Jantapo (11), from the conclusion of exercise in the elderly research,
it was found that regular exercise which means 3 - 5 times a week with at least 30 minutes can improve
muscle strength, together with upper body, core muscle, and limb muscle strength. It can also improve
moving agility and balancing skill, elasticity of muscle and joint in the elderly.
5. For stress and stress management, It was found that the elderly had less stress and had
appropriate stress management. This is consistent with the research of Wipaporn Sindhisart and Suchada
Suannum (9) found that elderly people can face with stress and various problems. As with the research of
Nittaya Srijamnong and Anchalee Jantapo ( 12) which conclude that mental health of the elderly is in
normal level.
ACKNOWLEDGEMENTS
I would like to express my sincere thanks to Suan Sunandha Rajabhat University for invaluable
help throughout this research.
REFERENCES
[1] Ministry of social development and human security, (2014), Thailand elderly population:
present and future, URL: https://www.m-society.go.th/article_attach/13225/17347.pdf.
[2] Department of Health (2014), “Exercise in the elderly”, URL:
http://library.thaihealth.or.th/.
[3] Surachet Duangthipsirikul & others, (2014), The Thai Geriatric Health Survey 2013 under the
Health Promotion Program of Elderly and disabled, URL: http://www.ucbp.net/.
[4] The Foundation of Thai Gerontology Research and Development Institute (2014), Situation of
The Thai Elderly, URL: http://thaitgri.org.
[5] Prawpan Suriwong , (2015), 3 Dimensions for Elderly Health Promotion, URL: http://www.
thaihealth.or.th.
[6] World Health Organization, (2002), What is active ageing?, URL: http://www.who.int/ageing/
active_ageing/en/ .
[7] Soraya Kaewpitul and Nuttawut Kaewpitul. (2011). Nutritional Status of the Elderly in Surin
Province. Nakhon Ratchasima: Suranaree University of Technology.
[8] Wajpolprasit Konkaew, (2014), Health behavior of elderly people living in the municipality.
Tambon Klong Ta, Muang Chon Buri. Master of Public Administration Program. College of
Public Administration, Burapa university.
[9] Wipaporn Sithisart, Suchada Suannum. (2007). Health promotion behavior of the elderly in the
community. Areas of responsibility Wat Phrathep Sub-district, Muang District, Phitsanulok
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 52
Province. Boromarajonani College of Nursing. Praboromarajchanok Institute. Ministry of
Public Health.
[10] Sriprai Phorsingh and Anong Harnsakul. (2012). Effect of Participatory Learning Program on
Knowledge and Self-Care Behavior of the Elderly in Nong Bua Khok District, Chatturat
District, Chaiyaphum Province. Journal of Disease Control 6, Khon Kaen. VOl.19, NO. 1, Pp.
39-53.
[11] Anchalee Jantapo, (2016), Quality of life of Female Prisoner, Central Prison,Udonthani, 4th
Suan Sunandha Academic National Conference on Research for Sustainable Development
2016, Suan Sunandha University, Thailand.
[12] Nitaya Srijamnong and Anchalee Jantapo, (2016), Mental Health of the Elderly, The 2017
International Academic Multidisciplines Research Conference, 9 July 2017, Novotel Zurich
Airport Messe Hotel Switzerland.
© ICBTS COPYRIGHT BY AUTHOR(S) THE 2018 INTERNATIONAL ACADEMIC RESEARCH CONFERENCE IN ZURICH 53
ATTENTION DEFICIT AND HYPERACTIVITY DISORDER
DISORDER IN PRESCHOOL PERIOD
Elif Yalçıntas Sezgin*, Leyla Ulus**
*Elif Yalçıntaş Sezgin, phd,lecturer, child development,uludağ universty, inegöl vocational
school,Bursa,Turkey
** Leyla Ulus, Assist. Prof. Dr, pre-school education İstanbul Üniversty Hasan Ali Yucel Faculty of
Education, Istanbul, Turkey
ABSTRACT
Attention deficit hyperactivity disorder (ADHD) which cause deterioration in functionality, is the most
common neuropsychiatric disorder in childhood today. Attention Deficit Hyperactivity Disorder (ADHD),
according to DSM-V, is defined with attention deficit, impulsivity and hyperactivity concepts (Häcker &
Stapf, 2004) Attention deficit hyperactivity disorder has 3 main subtypes; the character dominated by lack of
attention, the character dominated by hyperactivety-impulsive and related 3 more types. It is one of the most
seen problems in Early childhood and childhood periods. Pre-school children with Attention deficit and
hyperactivity disorder (ADHD), difficulties are experienced in diagnostics and education in Turkey. The aim
of this study in this context is to discuss the causes, prevalence, treatment and the other related disorders of
the character dominated by lack of attention (ADD) in Türkey . Writting was held on the basis of the studt is
only Attention Deficit Disorder. The conclusion has discussions, personal ideas and some advices.
Keywords: ADD, Attention Deficit Disorder, preschool period
INTRODUCTION
In recent years, there has been a great scientific and social interest in attention-
deficit/hyperactivity disorder (ADHD) (Hechtman and McGough, 2007). ADHD is a common
neurobehavioral disorder of childhood which leads to a prominent deterioration in the life quality of a patient
and the family. ADHD often takes years and it has biological, psychiatric, educational and social aspects.
Children who are diagnosed with ADHD have various difficulties such as lack of attention, inability to get
organized, and inability to provide the desired concentration in time. These problems lead to problems in the
academic and areas of competence, low school achievement and being excluded from a group of friends and
colleagues.
ADHD starts in the preschool period and it can also last into adulthood. It is a disorder which is
characterized with hyperactivity, short attention span and impulsivity. According to the DSM-IV-TR (2007),
ADHD is basically characterized by a persistent and continuous pattern of inattention and/or more frequent
and severe hyperactivity-impulsivity compared to peers. ADHD begins in childhood and it frequently lasts
into adulthood (60-70%). Similar to other diseases, ADHD also positively responds to early diagnosis and
treatment. However, it can lead to severe medical, academic and social problems in case it is not treated
(Ercan, 2010).
© ICBTS COPYRIGHT BY AUTHOR(S) THE 2018 INTERNATIONAL ACADEMIC RESEARCH CONFERENCE IN ZURICH 54
1. Attention Deficit Disorder
ADHD has three basic subtypes; predominantly inattentive type, predominantly hyperactive-impulsive
type, and the combination type.
In the predominantly inattentive type, "symptoms of attention deficit" are dominant. In this type, it is
possible that there are no symptoms of hyperactivity and impulsivity or symptoms are not significantly
severe. Severe distractibility can lead to problems such as delaying the work, having difficulties in getting
organized, avoiding the long-term tasks which require mental effort, inability to pay attention to details,
loosing belongings, inability to complete the tasks and severe forgetfulness while performing daily tasks.
The problem of children with attention deficit is being insufficient to start of finalize these functions on time
and in a right place. These children frequently need more help, and proper attitudes and behaviors should be
exhibited towards them. Furthermore, they need to be directed and reminded more according to their peers
who can easily perform these tasks in their daily lives (Brown, 2013). Characteristics of the predominantly
inattentive type of the disease were determined in the diagnoses criteria DSM-V (2014) and these are
specified as follows:
• The child mostly does not pay attention to details or classes at school, and frequently and carelessly
makes mistakes during activities at school (for instance; ignoring or skipping details or doing a
wrong job).
• The child mostly has difficulty to maintain the attention during any type of activity or while playing
games (for instance; having difficulty staying focused and attending to lectures, talks or reading
classes).
• It mostly appears that the child does not listen to others (for instance; it seems as that her/his mind
is somewhere else although there is no distraction).
• The child does not follow directions, and cannot complete the ordinary tasks and responsibilities
during the daily life and at school (for instance; the child starts the job, but he/she quickly loses the
focus and he/she is easily distracted).
• The child mostly has difficulty to organize the works and activities (having difficulty in managing
the sequential jobs, keeping the school equipments and personal belongings in order. The child
studies messy and disorganized and he/she has a bad time management and cannot obey time
limitations).
• The child mostly avoids anything that requires a sustained mental effort, does not like these kinds of
jobs and does not want to be involved in these activities (for instance; homework or responsibilities
at school, preparation of reports in the period of youth or adulthood, filling forms and reviewing
long texts).
• The child mostly loses her/his equipments, belongings and tools which are prepared for work or
certain activities (for instance; School supplies, pencils, books, everyday tools, wallet, keys,
articles, glasses, cell phones).
• The child is mostly and easily distracted by external stimuli (this can be observed as irrelevant
thoughts in youths and adults).
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• The child is often forgetful (having difficulties during routine and daily works, and errands, being
late to return phone calls in youths and adults, being late in paying bills and adjusting daily life
according to appointments).
According to DSM V (2014) criteria, at least six of these signs and symptoms should be observed
during at least six months for the ADD diagnosis.
1.2. Causes of Attention Deficit Disorder
Lack of attention is a disorder characterized by problems in concentrating, being forgetful and
disorganized, having difficulties in organizing tasks, being distracted easily during performing any kind of
job, avoiding the tasks which needs attention and ‘patience’ and frequently making simple mistakes (Ercan,
2008). Even though ADD is the most frequently studied disease in the child psychiatry, mechanisms
underlying the disorder have not yet been clarified. Various imaging techniques have been used in order to
examine the brain structure and functions in ADD. It was primarily suggested that involvement of
frontostriatal link was responsible for the disease. Additionally, it has been recently shown that the reason of
ADD can also be morphological alterations in temporoparietal lobe and cerebellum, basal ganglia and corpus
callosum (Giedd, 2010, Cherkasova, Hechtman, 2009). In the first metaanalysis which showed structural
abnormalities in magnetic resonance imaging (MRI), it was found that the maximum volumetric reduction
was observed in the most posterior inferior cerebellar vermis, corpus callosum splenial, right caudate
nucleus, total brain and right cerebral hemisphere of children with ADHD compared to controls (Valera,
Faraone, Murray, Seidman, 2007).
Recently, interaction of genetic and epigenetic factors related to ADHD and environment have been
actively examined. The mostly studied factors are as follows; maternal smoking and/or alcohol use during
pregnancy and dopaminergic genes, low birth weight, psychosocial problems, serotonergic genes and
disputes between parents (Pennington et al., 2009).
1.3. Attention Deficit Disorder and Preschool Period
Not all of ADD patients, but vast majority of them experience prominent problems. The incidence of
attention deficient disorder with/without hyperactivity is between 6% and 9% in school children (Sürmeli,
2010).
Children with ADD should be need directed and reminded more according to their peers who can
easily perform these tasks in their daily lives. Parents and acquaintances increasingly feel confusion and
despair as the child falls behind in learning the management of daily tasks and interactions in life and at
school. In order to achieve this, more than a particular talent is needed and child has a tendency to have
problems in self-management. Since children's growth rate varies from person to person, it is possible that
parents do not understand whether their children grow slowly or it is a matter of neurobehavioral disorder. In
the beginning, the child may seem to fail to understand and achieve the expectations of parents compared to
peers or there can be an unusual inconsistency in child’s behaviors. Parents are worried about this situation
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and they may suppose that their children should be more matured in order to perform these tasks compared
to their peers. This delay is generally very long in children with ADHD and the absence of the expected
development and maturation leads to an increasing concern. Children with ADHD have more injuries due to
their hyperactivity and disturbing behaviors (Hinhaw, 2002). Children with ADHD are highly restless and
fearless. Majority of peers ask for directions and help for some dangerous situations. However, children with
ADHD can be brave to touch hot or sharp things or walk across the street alone. They can resist against the
control of adults. Brown (2013) classifies prominent features of a child with ADD as follows.
1. Planning, establishing priorities and action: Children with ADD struggle when they start an
action. Even though it seems that they behave impulsively in some fields, it is generally observed
that they cannot initiate easily in case the task is not interesting for them. They postpone the
requirements and tasks until the last minute. They can motivate themselves only in the last minute
and when it is urgent. The reason for this is the existence of a problem in cognitive functions that
has become chronic.
2. Focus, maintaining, shifting attention to tasks: Children with ADHD have difficulties in paying
attention to things which is not interesting for her/him or which force her/him. Understanding the
meaning of sentences and paragraphs is an active process which requires a persistent and intense
focus and attention. Since these children cannot get their attention from interesting things, they can
have tendency to behave as they wish. This can deteriorate the social compliance and an individual
can avoid performing tasks which are expected or asked from him/her.
3. Children with ADHD generally feel themselves tired during the day. The problem of sleepiness
which can be observed while they are sitting or quietly standing is not due to being tired. Rather it
is the chronic problem of maintaining the viability. Due to the slow processing speed, these children
need extraordinarily long time to complete these kinds of tasks. Children with ADD show
reluctance to participate in works and games which requires attention and intense physical activity.
4. These children have difficulties in directing their feelings, they are less tolerant to disappointments,
they suffer while they are trying to cope with daily life stresses and they easily feel ‘overwhelmed’
and ‘nervous’. According to Brown (2013), Wender (1987, 1995) described that how individuals
with ADD syndrome are lost in ‘emotional instability’, how they frequently feel down, and how
they exhibit nervous complaints, furious behaviors or excitability which cannot be sufficiently
controlled. It was emphasized in the study that children with ADHD are less tolerant to
disappointments, they suffer while they are trying to cope with daily life stresses and they easily
feel ‘overwhelmed’ and ‘nervous’.
5. The use of process memory and reminiscence: Problems are generally related to the working
memory and it is not related to the storage memory. One of the most important functions of the
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working memory is to keep a small piece of information in an efficient way while dealing with
another work.
Working memory can be conceptualized as a desk where old and new data are constantly converted,
combined and transferred. It does not only store the knowledge, it is also similar to a very effective
calculation unit which efficiently processes instant information to enormous files of long-term memory.
Working memory is very important for the group or individual discussions in which an individual tries to
understand what is told and meanwhile prepares his/her answers to others. Children with ADHD have
frequently important problems in these simultaneous functions.
6. Follow-up and self-regulation action: Children with attention deficit cannot follow the
instructions from the beginning to the end, struggle to give attention to the work or play, lose the
equipments and belongings which are needed for activities at home or at school, do not listen
carefully, miss the details, appear uneven, struggle to perform activities which require mental effort
for a long time, they are forgetful and their attention easily shifts to another field.
1.4. Prevalence and Treatment
ADD is most commonly observed as a preschool disorder, it can lead to important academic, social
and psychiatric problems and its negative impacts can continue lifetime. Since it can affect the health of the
individual, family and society, ADHD is accepted as an important health problem. ADHD can start in the
early period of the life and it has a big impact on the individual's socialization (Retz and Rösler, 2009).
ADHD varies according to geographical regions and communities and its incidence is between 3%-
13%. In preschool period children, according to the Diagnostic and Statistical Manual of Mental Disorders
(DSM-III-R), AHDH was detected as 3.8-9.4% in Canada, 3.4% in Australia (DSM-III-R), 6.7% in small
children and 2-3% in adolescents in New Zealand (DSM-III-R), 4.2% in Germany, 5% in India, 7.5% in
Taiwan, 6-9% in China, 1.3% in adolescents in Netherlands, 9.5% in children and adolescents in Puerto
Rico, 7.7% in Japan, 2-13% in Colombia [DSM-IV], 5.8% in 12-14 year old children in Brazil (DSM
IV,1987; DSM IV,1994). American Psychiatric Association reports that the incidence of ADHD is between
5% and 7% in preschool children. According to a comprehensive metaanalysis study performed in 2008, it
was found that the prevalence of ADHD throughout the world was 5.29% (Polanczyk and Jensen, 2008).
In Turkey, the prevalence of ADHD is detected as 5% in Turkish primary school children living in
urban areas (Motavallı, 1994). In Trabzon, it was shown in a thesis study that ADHD rate was 2.81% in
primary school students (Yıldırım, 1998). These differences can be related to the diagnostic criteria, cultural
differences and limitations of methods used in studies. ADHD is more common among male and it has been
reported that the female-male rate of the disease is respectively 4:1 and 9:1 throughout the world (2). After
the change in the DSM-IV system and after sub types are formed, it was specified that the prevalence of
ADHD in children increased from 3-5% [DSM-III-R] to approximately 12% [DSM-IV] (DSM IV, 1987;
DSM IV,1994).
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The treatment of the ADD should be comprehensive since it affects the functionality of the child in
many areas. The primary aim of the ADD treatment is to solve behavioral, cognitive, social and familial
problems. An efficient treatment is composed of medication, psychotherapy and psychosocial therapies.
Family therapy, relaxation therapy, vitamin therapy, diet and ‘biofeedback’ therapies have been specified in
various studies. However, there is no study which has systematically examined the efficiency of these ADD
therapies. Psychosocial interventions can be family, school and child oriented. ADD assessments are
important in family oriented therapies (Kayaalp, 2008).
2. Conclusion
Preschool period is one of the most critical periods of a human life and it is important to diagnose and treat
this type of anxiety disorders during childhood. Therefore, particularly mothers should be careful observers
for the early diagnosis. No matter how much intelligence they have, children with lack of attention can be
compensated to some extent and they will be unsuccessful in the school life since they cannot focus on their
education. Children who are not treated can experience depression, anxiety disorder, tic and behavioral
disorders. The self-reliance of children can be deteriorated since they are continuously criticized by others.
Therefore, the disorder should be diagnosed in an early period and it should be efficiently treated on time. In
case it is noticed in early childhood years, providing efficient education and opportunities will minimize this
disadvantage during the developmental period of children. When preschool teachers notice something
outside the norm, they should inform families and they should direct them for the early diagnosis and the
treatment.
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© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 60
ASSESSING THE IMPACT OF MAXIMIZING TENDENCY ON
CAREER OUTCOMES OF INDIAN IT PROFESSIONALS
Prof Vijai N Giri and Sayoni Santra
Dept. of Humanities & Social Sciences, Indian Institute of Technology Kharagpur, India
ABSTRACT
The changing dynamics of career landscape with a plethora of opportunities, easy availability of diverse
resources and multiple information have opened gateways for todays’ professionals to envision attractive
career choices. In response to this, some people engage exhaustively in career decision-making processes,
reflecting an inclination towards accomplishing the best that is manifested through their tendency to
maximize. Though literature has explored such tendency within individuals’ career domain, but its in-depth
impression in real world of work is yet understudied. We examined maximizing approach in career decision-
making of IT professionals in India and comprehended how it influenced their career outcomes. It was found
that there was a duality in maximizing tendency, capturing the dimensions of “striving for career excellence”
and “ state of internal career ambiguities” . While “ striving for career excellence” increased career
satisfaction, “ state of internal career ambiguities” intensified intentions of turnover. The implications and
limitation of findings have been discussed.
Keywords: Career decision-making, career satisfaction, maximizing tendency, turnover intention
© ICBTS Copyright by Author(s) The 2018 International Academic Research Conference in Zurich 61
SOCIAL MEDIA USAGE IN INTERNAL CORPORATE
COMMUNICATION
Gülçin İpek Emeksiz
Anadolu University, Turkey
ABSTRACT
Social media has turned into an indispensable tool for many companies worldwide. Many companies
use social media to reach their existing and prospective customers in a convenient way. These companies not
only introduce their new products on social media, but also engage their customers to their brands with the
dialogue they provide. The two-way communication in social media helps companies to get feedback about
their brands and companies can improve their brands with that information they get. Therefore, companies
gain many advantages from their social media usage. Indeed, most of the researches which have been carried
on social media give priority to how companies use social media in their external communication activities
with their customers. Therefore, this research aims to draw attention to the internal corporate communication
aspect of social media usage of companies. This research examines what kind of benefits companies gain and
what kind of disadvantages they come across out of their social media usage in internal corporate
communication. The results of the research indicate that companies which use social media in their internal
corporate communication activities are perceived as pioneering as these companies get more efficiency from
their internal corporate communication. However, the main disadvantages of social media usage in internal
corporate communication are encountering with cyber-attacks and the leakage of significant information. This
research will present a concise evaluation towards social media usage in internal corporate communication
from different perspectives.
Keywords: social media, internal corporate communication, benefits, disadvantages